Evaluation of Biomechanically Corrected Intraocular Pressure Measurements in Keratoconus and Forme Fruste Keratoconus

Introduction: Although biomechanically corrected intraocular pressure (bIOP) is available, the effectiveness of intraocular pressure (IOP) correction in keratoconus and forme fruste keratoconus (FFK) eyes has not been investigated. Objective: Evaluation of bIOP measurements in eyes with keratoconus and FFK. Methods: Forty-two eyes in 21 patients with keratoconus in one eye and FFK in the fellow eye were examined (KC/FFK group; mean age 24.62 +/- 8.6 years; 16 males and 5 females). The control group consisted of 62 eyes in 31 unaffected subjects (mean age 26.26 +/- 3.64 years; 15 males and 16 females). The bIOP was determined using a Scheimpflug-based tonometer (Corvis Scheimpflug Technology [Corvis ST (R)]) after measuring the IOP with a conventional non-contact tonometer (NIOP). The agreement between NIOP and bIOP values was examined using the Bland-Altman plot. The difference between NIOP and bIOP (bIOP correction amount) was compared between keratoconus and FFK eyes. Results: In the control group, there were no significant differences between right and left eyes in both NIOP and bIOP values (p = 0.975 and p = 0.224, respectively). In the KC/FFK group, NIOP values were significantly lower in the keratoconus eyes (9.93 +/- 1.96 mm Hg) than in the FFK eyes (12.23 +/- 3.03 mm Hg; p = 0.0003). There was no significant difference in bIOP values between the right and left eyes of the KC/FFK group (p = 0.168). The bIOP correction amount was significantly increased in keratoconus eyes (3.58 +/- 2.12 mm Hg) compared to in FFK eyes (1.80 +/- 3.32 mm Hg; p = 0.011). Conclusions: For eyes with keratoconus and FFK, the bIOP method is effective to adjust IOP measurements based on corneal biomechanical properties.