ESCRS - P138 - NEW AIR ESTHESIOMETER CLINICAL TRIAL: PRELIMINARY RESULTS.

NEW AIR ESTHESIOMETER CLINICAL TRIAL: PRELIMINARY RESULTS.

Published 2023 - 27th ESCRS Winter Meeting

Reference: P138 | Type: Free Paper Submission | DOI: 10.82333/6v3y-bq33

Authors: Damian Garcia-Teillard* 1 , Salvador Garcia-Delpech 2 , J.M Benitez Del Castillo 3 , J. MERAYO 4 , J. Montero 5 , P. UDAONDO 2 , Alex S. Fernández-Santodomingo 2

1OFTALMOLOGIA,HOSPITAL PUNTA DE EUROPA,ALGECIRAS,Spain, 2OFTALMOLOGIA,CLINICA AIKEN,VALENCIA,Spain, 3OFTALMOLOGIA,CLINICA REMENTERIA,MADRID,Spain, 4OFTALMOLOGIA,INSTITUTO OFTALMOLOGICO FERNANDEZ-VEGA,OVIEDO,Spain, 5OFTALMOLOGIA,CARTUJA VISION,SEVILLA,Spain

Purpose

To determine corneal sensitivity with a new air esthesiometer (CEB) on a given population of patients.

Setting

Dry eye disease is a prevalent condition1,2,3,4. It is known that dry eye disease can lead to corneal hypoesthesia due to neuropathy6,7, resulting in recurrent erosions and corneal epitheliopathy8.

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 sensitivity 12, nevertheless, older esthesiometry devices are seen to report underestimated results9,12. In the other hand, new non-contact techniques have appeared, showing promising results9.

Last ESCRS winter edition we presented our first esthesiometry results. We drew the conclusion that device’s pressure level had to be ranged towards lower values, so that we could differentiate normal cases from milder ones with a higher sensibility, as well as detecting patients with corneal hypoesthesia. We present this time our preliminary results for corneal sensitivity measurements with this new non-contact esthesiometer parameters.

Methods

Corneal sensitivity was measured in 40 (eyes). Data came from a population of: 

-     Healthy volunteers with and without contact lens

-    Patients with neurotrophic  and band keratopathy

-     Glaucoma, post vitrectomy and corneal graft patients.

-     Myopic LASIK refractive surgery 

-     Phacoemulsification 

-     Photorefractive keratectomy surgery 


The esthesiometer has 5 levels of stimuli, ranging from 4 mbar to 25 mbar for a surface of 0.4 mm diameter. Measurements were carried with support on the Slit Lamp.

Results

Healthy volunteers felt the air pulse at 4 and 5 mbar. 

Patients with neurotrophic keratopathy (NK) and band keratopathy (BK) having with corneal edema needed higher levels of pressure (8 mbar), while the eye treated with Oxervate was stimulated at a lower intensity (4 mbar)

Phaco surgery patients needed lower intensity for stimuli (4 and 2 mbar) one week after surgery, while one month after surgery they needed higher intensity stimuli ( 5 to 7 mbar) 

In the case of LASIK patients, we found a situation opposite to the previous one: as time went by, cornea needed lower intensities to be stimulated (raging from 7 mbar one week post LASIK to 4 mbar one year post LASIK)

We didn’t find differences across time for patients having undergone PRK procedure.

Conclusion

It appears that having new pressure levels ranged towards lower values (as compared to previous device prototype) helped us differentiated normal from mild cases with higher sensibility. 

 Given these results, it would be interesting to determine sensitivity reference intervals for CBE in healthy corneas. For that, a new study is being carried exclusively on healthy patients.