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. 2025 Jul 1;25(1):385.
doi: 10.1186/s12886-025-04095-8.

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

Ali Azimi  1 , Elham Sadeghi  2   3 , Hamidreza Hassanipour  1 , Pardis Bostanian  1 , Alireza Attar  4 , Dorna Eghtedari  1 , Zahra Sharafi  1 , Hooman Razmi  1 , Rajesh S Kumar  5 , Ian Conner  5
Affiliations

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

Ali Azimi et al. BMC Ophthalmol. .

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.

Keywords: CORVIS; Glaucoma; Open-angle glaucoma; Pentacam; Viscocanalostomy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Informed consents were obtained in all cases. All methods and experimental protocols were under the tenets of the Declaration of Helsinki and approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.MED.REC.1402.277). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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