Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma

Abstract Purpose To assess corneal biomechanical changes after phacoemulsification and ab-externo viscocanalostomy (phaco-visco) surgery in patients with open-angle glaucoma (OAG). Methods Patients with OAG and cataract, visual acuity < 20/40 Snellen, were included. Pre- and postoperative evaluat...

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Main Authors: Ali Azimi, Elham Sadeghi, Hamidreza Hassanipour, Pardis Bostanian, Alireza Attar, Dorna Eghtedari, Zahra Sharafi, Hooman Razmi, Rajesh S Kumar, Ian Conner
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04095-8
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author Ali Azimi
Elham Sadeghi
Hamidreza Hassanipour
Pardis Bostanian
Alireza Attar
Dorna Eghtedari
Zahra Sharafi
Hooman Razmi
Rajesh S Kumar
Ian Conner
author_facet Ali Azimi
Elham Sadeghi
Hamidreza Hassanipour
Pardis Bostanian
Alireza Attar
Dorna Eghtedari
Zahra Sharafi
Hooman Razmi
Rajesh S Kumar
Ian Conner
author_sort Ali Azimi
collection DOAJ
description Abstract Purpose To assess corneal biomechanical changes after phacoemulsification and ab-externo viscocanalostomy (phaco-visco) surgery in patients with open-angle glaucoma (OAG). Methods Patients with OAG and cataract, visual acuity < 20/40 Snellen, were included. Pre- and postoperative evaluations were performed. Keratometric and aberrometry assessments were done with Oculus Pentacam AXL, and corneal biomechanics were evaluated using Corvis ST. Wilcoxon signed-rank and Chi-square tests were used. Results This study included 30 eyes from 28 patients with OAG who underwent phaco-visco surgery. The mean age was 67.57 ± 9.20 years, with 50% being male. The mean postoperative follow-up duration was 4.1 ± 2.1 months. Postoperatively, biomechanically corrected intraocular pressure (bIOP) significantly decreased (-1.8 ± 4.7, P = 0.008), while central corneal thickness (CCT) showed no significant change (+ 0.333 ± 9.536, P = 0.810). Significant increases were observed in deflection amplitude max (+ 0.841 ± 0.173, P = 0.002), peak distance (+ 0.242 ± 0.458, P = 0.001), front astigmatism (+ 0.210 ± 0.420, P = 0.013), index of height asymmetry (+ 3.146 ± 6.374, P = 0.015), and index of height deviation (+ 0.007 ± 0.010, P = 0.001). Additionally, anterior chamber (AC) parameters such as AC depth (P = 0.001) and AC volume (P < 0.001) significantly increased following surgery. Conclusions This study shows that phaco-visco surgery in OAG eyes may increase corneal softening, decrease bIOP without altering CCT, induce corneal front astigmatism, and cause AC parameters changes. Corvis ST helps for more accurate IOP assessment and toric IOL planning.
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spelling doaj-art-eef9428804de4fc58ae80b132022fe4d2025-08-20T03:37:20ZengBMCBMC Ophthalmology1471-24152025-07-012511710.1186/s12886-025-04095-8Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucomaAli Azimi0Elham Sadeghi1Hamidreza Hassanipour2Pardis Bostanian3Alireza Attar4Dorna Eghtedari5Zahra Sharafi6Hooman Razmi7Rajesh S Kumar8Ian Conner9Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesSchool of Medicine, University of PittsburghPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesSchool of Medicine, University of PittsburghSchool of Medicine, University of PittsburghAbstract Purpose To assess corneal biomechanical changes after phacoemulsification and ab-externo viscocanalostomy (phaco-visco) surgery in patients with open-angle glaucoma (OAG). Methods Patients with OAG and cataract, visual acuity < 20/40 Snellen, were included. Pre- and postoperative evaluations were performed. Keratometric and aberrometry assessments were done with Oculus Pentacam AXL, and corneal biomechanics were evaluated using Corvis ST. Wilcoxon signed-rank and Chi-square tests were used. Results This study included 30 eyes from 28 patients with OAG who underwent phaco-visco surgery. The mean age was 67.57 ± 9.20 years, with 50% being male. The mean postoperative follow-up duration was 4.1 ± 2.1 months. Postoperatively, biomechanically corrected intraocular pressure (bIOP) significantly decreased (-1.8 ± 4.7, P = 0.008), while central corneal thickness (CCT) showed no significant change (+ 0.333 ± 9.536, P = 0.810). Significant increases were observed in deflection amplitude max (+ 0.841 ± 0.173, P = 0.002), peak distance (+ 0.242 ± 0.458, P = 0.001), front astigmatism (+ 0.210 ± 0.420, P = 0.013), index of height asymmetry (+ 3.146 ± 6.374, P = 0.015), and index of height deviation (+ 0.007 ± 0.010, P = 0.001). Additionally, anterior chamber (AC) parameters such as AC depth (P = 0.001) and AC volume (P < 0.001) significantly increased following surgery. Conclusions This study shows that phaco-visco surgery in OAG eyes may increase corneal softening, decrease bIOP without altering CCT, induce corneal front astigmatism, and cause AC parameters changes. Corvis ST helps for more accurate IOP assessment and toric IOL planning.https://doi.org/10.1186/s12886-025-04095-8Open-angle glaucomaGlaucomaViscocanalostomyCORVISPentacam
spellingShingle Ali Azimi
Elham Sadeghi
Hamidreza Hassanipour
Pardis Bostanian
Alireza Attar
Dorna Eghtedari
Zahra Sharafi
Hooman Razmi
Rajesh S Kumar
Ian Conner
Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
BMC Ophthalmology
Open-angle glaucoma
Glaucoma
Viscocanalostomy
CORVIS
Pentacam
title Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
title_full Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
title_fullStr Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
title_full_unstemmed Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
title_short Changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open-angle glaucoma
title_sort changes of corneal biomechanical and biometrical properties after combined phacoemulsification with viscocanalostomy surgery in patients with open angle glaucoma
topic Open-angle glaucoma
Glaucoma
Viscocanalostomy
CORVIS
Pentacam
url https://doi.org/10.1186/s12886-025-04095-8
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