FIRST RESULTS FOR A NEW NON-CONTACT CORNEAL ESTHESIOMETER

Published 2022 - 26th ESCRS Winter Meeting

Reference: MP11 | Type: Abstracts | DOI: 10.82333/p1cm-wv89

Authors: Damian Garcia-Teillard ¹ , Salvador Garcia-Delpech* ² , Anabel Martinez Espert ³ , Patricia Udaondo Mirete ² , Alex Fernandez ² , Jose Manuel Benitez del Castillo ⁴

¹OFTALMOLOGIA,SAS-HPE,Algeciras,Spain, ²OFTALMOLOGIA,AIKEN,VALENCIA,Spain, ³OFTALMOLOGIA,AIKEN,VALENCIA,Spain;ÓPTICA OPTOMETRIA,UNIVERSITAT DE VALÈNCIA,VALENCIA,Spain, ⁴OFTALMOLOGIA,Universidad Complutense de Madrid, Clinica Rementería,Madrid,Spain

Purpose

To evaluate the efficacy of a new air esthesiometer in assessing corneal sensitivity in a selected group of patients

Setting

Dry eye disease is a prevalent condition^1,2,3,4, representing a high cost to first world countries’ health systems¹. It is known that dry eye disease can lead to corneal hypoesthesia due to neuropathy^6,7, resulting in recurrent erosions and corneal epitheliopathy⁸.It has been reported that many processes such as cataract surgery, LASIK surgery, or systemic diseases like Sjogren syndrome or Diabetes Mellitus are associated to corneal neuropathy, loss of corneal nerve bundles and dry eye disease.^9,10,11. Thus, measuring corneal sensitivity when facing dry eye disease patients should be crucial for ophthalmologists as clinicians⁶.Esthesiometers help in assessing corneal sensitivity¹². Nevertheless, older esthesiometry devices are seen to report underestimated results^9,12. In the other hand, new non-contact techniques have appeared, showing promising results⁹.

Methods

Corneal sensitivity was evaluated in 16 patients (32 eyes). Assessments were carried out manually, without support of the esthesiometer on the Slit Lamp. We used the new CORNEAL ESTHESIOMETER BRILL (BRILL ENGINES, Barcelona, Spain) that has 5 pressure levels, in a range from 4 mbar to 25 mbar for a surface of 0.4 mm in diameter. It can be used manually or by leaning on the slit lamp. Within the sample we found normal patients, patients with neurotrophic keratopathy, band keratopathy, endothelial dystrophy, keratopathy due to graft-versus-host disease or post meningioma radiation, patients with rheumatoid arthritis, punctate keratopathy due to dry eye, or Sjogren’s syndrome. We also included patients who had undergone myopic LASIK refractive surgery 1 month and 3 months before, as well as patients having had cataract surgery in the 1^st, 2^nd, and 4^th previous weeks

Results

N (EYES) PATHOLOGY PRESSURE LEVEL (intensity for stimuli)

13 None 1

2 Graft Vs Host disease 3

1 Type II neurotrophic keratopathy 3

1 Type IV neurotrophic keratopathy 3

1 Band keratopathy (limbal insufficiency) 4

1 Endothelial dystrophy + corneal oedema 3

1 Endothelial dystrophy without oedema 1

2 Rheumatoid arthritis 2

4 Sjogren disease 2

2 Sjogren disease 1

2 Punctate keratopathy 2

2 1 month post PHACO surgery 1

1 1 week post PHACO surgery 1

1 2 weeks post PHACO surgery 1

2 3 months post LASIK 1

2 1 month post LASIK 1

Conclusion

Patients with neurotrophic keratopathy need higher levels of pressure to feel the pulse of air.

In the other hand, patients who should present lower sensitivity values (that means a higher level of intensity of pressure is needed to trigger a response), as is the case of patients undergoing refractive surgery, presented a sensitivity equal to that of a healthy cornea.

Therefore, it would be interesting to broaden the pressure level range towards lower values, so that we could differentiate normal cases from mild ones. Then, pressure level 5 could be removed from the device, as many of the most complicated cases responded to intensity level 4.