Use of Corneal hysteresis and Corneal Resistance Factor in Target Intraocular Pressure Estimation in Patients with Early Primary Open Angle Glaucoma

Abstract Purpose: To introduce a new method for estimation of the target intraocular pressure (TIOP) in naïve eyes with early primary open angle glaucoma (POAG) using Corneal hysteresis (CH) and corneal resistance factor (CRF).Methods: A prospective quasi-experimental study was conducted on naïve 90 eyes of 45 patients who were newly diagnosed with early primary open angle glaucoma (POAG). They were compared to 72 eyes of 36 normal subjects. The TIOP was determined for each eye. The IOP Goldmann (IOPg), IOP corneal-compensated (IOPcc), CH and CRF were estimated by Ocular Response Analyzer (ORA, Reichert) device. Measurements were taken for each patient prior to treatment and after 1, 3, 6, 9 and 12 months of receiving medications; either monotherapy or combination therapy.Results: For all patients, there was a significant negative correlation (p < 0.05) between IOP, either IOPg or IOPcc, and CH while a significant positive relationship (p < 0.05) existed between IOP and CRF. For patients with early POAG, The CH was significantly increased (p ≤ 0.001) while CRF was significantly decreased (p ≤ 0.001) when TIOP was achieved. At IOP levels higher than TIOP, CH value was lower than CRF with a significant negative correlation between them in contrast to controls. This correlation was reversed on reaching TIOP and CH values became higher than CRF similar to controls.Conclusion: CH, CRF and IOP measured by ORA can be used for TIOP estimation. This provides us with a guide for assessing the effectiveness of medications introduced to patients with POAG.