Biomechanische Analyse von tomografisch unauffälligen Keratokonus-Partneraugen mit dem Corvis ST

Victor A. Augustin; Hyeck-Soo Son; Bogdana Kovalchuk; Timur Mert Yildirim; Maximilian K. Köppe; Gerd U. Auffarth; Ramin Khoramnia

doi:10.1055/a-2130-7503

Klinische Monatsblätter für Augenheilkunde, Inhaltsverzeichnis

Klin Monbl Augenheilkd 2023; 240(08): 944-951
DOI: 10.1055/a-2130-7503

Klinische Studie

Biomechanical Analysis of Tomographically Regular Keratoconus Fellow Eyes Using Corvis ST

Artikel in mehreren Sprachen: deutsch | English

Victor A. Augustin

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Hyeck-Soo Son

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Bogdana Kovalchuk

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Timur Mert Yildirim

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Maximilian K. Köppe

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Gerd U. Auffarth

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

,

Ramin Khoramnia

Universitäts-Augenklinik Heidelberg, David J. Apple International Laboratory for Ocular Pathology und International Vision Correction Research Centre (IVCRC), Heidelberg, Deutschland

› Institutsangaben

Abstract

Background Keratoconus is a bilateral, yet asymmetric disease. In rare cases, the second eye may show no signs of tomographic changes. The purpose of this study was to analyze the biomechanical characteristics in tomographically regular keratoconus fellow eyes.

Materials and Methods This retrospective, consecutive case series analyzed 916 eyes of 458 patients who presented to our keratoconus clinic between November 2020 and October 2022. Primary outcome measures included best-corrected visual acuity (BCVA), tomographic Scheimpflug analysis using Pentacam AXL (Oculus, Wetzlar, Germany), and biomechanical assessment using Corvis ST (Oculus, Wetzlar, Germany). Tomographic changes were assessed via analysis of the anterior and posterior curvature, K-max, thinnest corneal thickness (TCT), the Belin/Ambrosio Deviation Display (BAD-D), and the ABCD-Grading. Biomechanical changes were analyzed using Corvis Biomechanical Index (CBI) and Tomographic Biomechanical Index (TBI).

Results Of 916 eyes, 34 tomographically regular fellow eyes (7.4%) were identified and included in the analysis. Overall, the mean BCVA was − 0.02 ± 0.13 logMAR. Tomographic analysis showed mean K-max of 43.87 ± 1.21 D, mean TCT of 532 ± 23 µm, and mean BAD-D of 1.02 ± 0.43. Biomechanical analysis demonstrated mean CBI of 0.28 ± 0.26 and mean TBI of 0.34 ± 0.30. While normal CBI-values were observed in 16 (47%) of 34 eyes, only 13 eyes (38%) showed a regular TBI and only 7 eyes (21%) showed regular TBI and CBI. The sensitivity of CBI and TBI to detect a tomographically normal keratoconus fellow eye was 53% and 62%, respectively.

Conclusion A highly asymmetric corneal ectasia with regular tomographic finding in a fellow eye is rare among keratoconus patients. In such cases, a biomechanical analysis may be useful in detecting early signs of corneal ectasia. In our analysis, the TBI showed high sensitivity for detecting a biomechanical abnormality in tomographically regular fellow eyes.

Key words

keratoconus - subclinical keratoconus - biomechanics - Corvis ST - CBI - TBI

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Referenzen

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