A comparison of the corneal biomechanics in pseudoexfoliation syndrome, pseudoexfoliation glaucoma, and healthy controls using Corvis® Scheimpflug Technology

Purpose: To compare the corneal biomechanical parameters among pseudoexfoliation syndrome (PXF), pseudoexfoliation glaucoma (PXG), and healthy controls using Corvis Scheimpflug Technology (ST). Methods: A prospective, cross-sectional study of 141 treatment-naive eyes that underwent Corvis ST was conducted. These included 42 eyes with PXF, 17 eyes of PXF with ocular hypertension (PXF + OHT) defined as intraocular pressure (IOP) >21 mmHg without disc/field changes, 37 eyes with PXG, and 45 healthy controls. Corneal biomechanical parameters, which included corneal velocities, length of corneal applanated surface, deformation amplitude (DA), peak distance, and radius of curvature, were compared among the groups using analysis of variance models. Results: The four groups were demographically similar. The mean IOP was lower in the controls (15.6 +/- 3 mmHg) and PXF group (16.0 +/- 3 mmHg) compared to the other two groups (>24 mmHg). Corneal pachymetry was similar across the four groups. Mean DA was significantly lower (P < 0.0001) in the PXG group (0.91 +/- 0.18 mm) and the PXF + OHT group (0.94 +/- 0.13 mm) when compared to the PXF (1.10 +/- 0.11 mm) and control groups (1.12 +/- 0.14 mm). Corneal velocities were also found to be statistically significantly lower in PXG and PXF + OHT compared to the PXF and control groups. However, after adjusting for age and IOP, there was no difference in any of the biomechanical parameters among the four groups. Conclusion: Corneal biomechanical parameters measured on Corvis ST are not different between healthy controls and eyes with PXF and PXG. Since PXG is a high-pressure glaucoma, corneal biomechanics may not play an important role in its diagnosis and pathogenesis.