Skip to main content

Advertisement

SpringerLink
Log in

Biomechanical properties of the cornea following intravitreal ranibizumab injection

  • Cornea
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Objective

To evaluate intraocular pressure (IOP) and corneal biomechanical properties changes after intravitreal ranibizumab injection (IVRI).

Methods

One hundred twenty eyes of 120 patients who underwent IVRI between January and March 2018 in Adnan Menderes University Ophthalmology Clinic were included in study. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured by Ocular Response Analyzer (ORA) by the same specialist preoperatively (preop), postoperative 1st (postop-1st), postoperative 3rd (postop-3rd), and postoperative 24th hours (postop-24th) after single-dose IVRI.

Results

Among the 120 wet age-related macular degeneration subjects, 58 (48.3%) were female and 62 (51.7%) were male. The mean age was 64.8 ± 10.4 years. Postop-1st hour IOP cc and IOPg measurements were statistically different from all other measurements (p < 0.001). Postop-1st hour CH measurements were statistically different from preop and postop-3rd (p = 0.022 and p = 0.008, respectively).

Conclusion

After intravitreal injection, IOP pressures significantly increased. But, CH and CRF values were significantly decreased. All these changes were temporary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ambati J, Atkinson JP, Gelfand BD (2013) Immunology of age-related macular degeneration. Nat Rev Immunol 13(6):438–451

    Article  CAS  Google Scholar 

  2. Qin VL, Young J, Silva FQ, Conti FF, Singh RP (2018) Outcomes of patients with exudative age-related macular degeneration treated with antivascular endothelial growth factor therapy for three or more years: a review of current outcomes. Retina. 38(8):1500–1508

    Article  CAS  Google Scholar 

  3. Peden MC, Suñer IJ, Hammer ME, Grizzard WS (2015) Long-term outcomes in eyes receiving fixed-interval dosing of anti-vascular endothelial growth factor agents for wet age-related macular degeneration. Ophthalmology. 122(4):803–808

    Article  Google Scholar 

  4. McCannel CA (2011) Meta-analysis of endophthalmitis after intravitreal injection of anti-vascular endothelial growth factor agents. Retina. 31:654–661

    Article  CAS  Google Scholar 

  5. Tolentino M (2011) Systemic and ocular safety of intravitreal anti-VEGF therapies for ocular neovascular disease. Surv Ophthalmol 56:95–113

    Article  Google Scholar 

  6. Bakri SJ, Pulido JS, McCannel CA, Hodge DO, Diehl N, Hillemeier J (2009) Immediate intraocular pressure changes following intravitreal injections of triamcinolone, pegaptanib, and bevacizumab. Eye. 23(1):181–185

    Article  CAS  Google Scholar 

  7. Gismondi M, Salati C, Salvetat ML, Zeppieri M, Brusini P (2009) Short-term effect of intravitreal injection of ranibizumab (Lucentis) on intraocular pressure. J Glaucoma 18(9):658–661

    Article  Google Scholar 

  8. Ladas ID, Karagiannis DA, Rouvas AA, Kotsolis AI, Liotsou A, Vergados I (2009) Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections. Retina. 29(3):313–318

    Article  Google Scholar 

  9. ElMallah MK, Asrani SG (2008) New ways to measure intraocular pressure. Curr Opin Ophthalmol 19(2):122–126

    Article  Google Scholar 

  10. Al-Mubrad TM, Ogbuehi KC (2007) Clinical investigation of the effect of topical anesthesia on intraocular pressure. Clin Ophthalmol 1(3):305–309

    Google Scholar 

  11. Whitacre MM, Stein R (1993) Sources of error with use of Goldmann-type tonometers. Surv Ophthalmol 38(1):1–30

    Article  CAS  Google Scholar 

  12. Luce DA (2005) Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg 31:156–162

    Article  Google Scholar 

  13. Wasielica-Poslednik J, Berisha F, Aliyeva S, Pfeiffer N, Hoffmann EM (2010) Reproducibility of ocular response analyzer measurements and their correlation with central corneal thickness. Graefes Arch Clin Exp Ophthalmol 248(11):1617–1622

    Article  Google Scholar 

  14. Medeiros FA, Meira-Freitas D, Lisboa R, Kuang TM, Zangwill LM, Weinreb RN (2013) Corneal hysteresis as a risk factor for glaucoma progression: a prospective longitudinal study. Ophthalmology. 120(8):1533–1540

    Article  Google Scholar 

  15. Kirgiz A, Karaman Erdur S, Atalay K, Gurez C (2019) The role of ocular response analyzer in differentiation of forme fruste keratoconus from corneal astigmatism. Eye Contact Lens 45:83–87

    Article  Google Scholar 

  16. Congdon NG, Broman AT, Bandeen-Roche K, Grover D, Quigley HA (2006) Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol 141:868–875

    Article  Google Scholar 

  17. Pepose JS, Feigenbaum SK, Qazi MA, Sanderson JP, Roberts CJ (2007) Changes in corneal biomechanics and intraocular pressure following LASIK using static, dynamic, and noncontact tonometry. Am J Ophthalmol 143(1):39–47

    Article  Google Scholar 

  18. Brown DM, Michels M, Kaiser PK, Heier JS, Sy JP, Ianchulev T (2009) Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 116(1):57–65

    Article  Google Scholar 

  19. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY (2006) Ranibizumab for neovascular agerelated macular degeneration. N Engl J Med 355(14):1419–1431

    Article  CAS  Google Scholar 

  20. Park J, Lee M (2018) Short-term effects and safety of an acute increase of intraocular pressure after intravitreal bevacizumab injection on corneal endothelial cells. BMC Ophthalmol 18(1):17

    Article  Google Scholar 

  21. SooHoo JR, Seibold LK, Kahook MY (2014) The link between intravitreal antivascular endothelial growth factor injections and glaucoma. Curr Opin Ophthalmol 25(2):127–133

    Article  Google Scholar 

  22. Sternfeld A, Ehrlich R, Weinberger D, Dotan A (2020) Effect of different lens status on intraocular pressure elevation in patients treated with anti-vascular endothelial growth factor injections. Int J Ophthalmol 13(1):79–84

    Article  Google Scholar 

  23. Arslan GD, Guven D, Alkan AA, Kacar H, Demir M (2019) Short term effects of intravitreal anti-vascular endothelial growth factor agents on cornea, anterior chamber, and intraocular pressure. Cutan Ocul Toxicol 38(4):344–348

    Article  Google Scholar 

  24. Bakri SJ, Snyder MR, Reid JM, Pulido JS, Ezzak MK, Singh RJ (2007) Pharmacokinetics of intravitreal ranibizumab (Lucentis). Ophthalmology. 114(12):2179–2182

    Article  Google Scholar 

  25. Hollands H, Wong J, Bruen R, Campbell RJ, Sharma S, Gale J (2007) Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol 42:807–811

    Article  Google Scholar 

  26. Kahook MY, Kimura AE, Wong LJ, Ammar DA, Maycotte MA, Mandava N (2009) Sustained elevation in intraocular pressure associated with intravitreal bevacizumab injections. Ophthalmic Surg Lasers Imaging 40:293–295

    Article  Google Scholar 

  27. Hoang QV, Mendonca LS, Della Torre KE, Jung JJ, Tsuang AJ, Freund KB (2012) Effect on intraocular pressure in patients receiving unilateral intravitreal anti-vascular endothelial growth factor injections. Ophthalmology. 119:321–326

    Article  Google Scholar 

  28. Shoeibi N, Ansari-Astaneh MR, Sedaghat MR, Shokoohi RS (2019) Effect of intravitreal bevacizumab injection on corneal in vivo biomechanics: a pilot study. J Ophthalmic Vis Res 14(2):151–156

    Article  Google Scholar 

  29. Sniegowski M, Mandava N, Kahook MY (2010) Sustained intraocular pressure elevation after intravitreal injection of bevacizumab and ranibizumab associated with trabeculitis. Open Ophthalmol J 4:28–29

    Article  CAS  Google Scholar 

  30. Mitchell P, Korobelnik JF, Lanzetta P, Holz FG, Prünte C, Schmidt-Erfurth U, Tano Y, Wolf S (2010) Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials. Br J Ophthalmol 94(1):2–13

    Article  CAS  Google Scholar 

  31. Susanna CN, Diniz-Filho A, Daga FB, Susanna BN, Zhu F, Ogata NG, Medeiros FA (2018) A prospective longitudinal study to investigate corneal hysteresis as a risk factor for predicting development of glaucoma. Am J Ophthalmol 187:148–152

    Article  Google Scholar 

  32. Zhang C, Tatham AJ, Abe RY, Diniz-Filho A, Zangwill LM, Weinreb RN, Medeiros FA (2016) Corneal hysteresis and progressive retinal nerve fiber layer loss in glaucoma. Am J Ophthalmol 166:29–36

    Article  Google Scholar 

  33. Fontes BM, Ambrósio R Jr, Velarde GC, Nosé W (2011) Corneal biomechanical evaluation in healthy thin corneas compared with matched keratoconus cases. Arq Bras Oftalmol 74:13–16

    Article  Google Scholar 

  34. Kamiya K, Hagishima M, Fujimura F, Shimizu K (2008) Factors affecting corneal hysteresis in normal eyes. Graefes Arch Clin Exp Ophthalmol 246:1491–1494

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Health Sciences Izmir Dr. Behcet Uz Children’s Diseases and Surgery Training and Research Hospital, Izmir, Turkey

    Sinan Bekmez

  2. Department of Ophthalmology, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey

    Harun Cakmak, Tolga Kocaturk & Sema Dundar

  3. Department of Biostatistics, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey

    Fulden Cantas

Authors
  1. Sinan Bekmez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Harun Cakmak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tolga Kocaturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fulden Cantas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sema Dundar
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SB, HC: designed the study; SB, TK: were involved in patient care; SB: collected the data; SB, FC, SD: analysis and interpretation of data; SB, HC: drafting the manuscript; TK, SD: design of the work, revising the work critically for important intellectual content. All authors approved the final version of manuscript.

Corresponding author

Correspondence to Sinan Bekmez.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This report was approved by the Faculty of Medicine, Adnan Menderes University, Aydin, Turkey, research ethics committee and followed the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This manuscript has not been published elsewhere previously nor is it being simultaneously considered for publication elsewhere.

Highlights

• Intravitreal anti-VEGF is the main treatment modal for wet age-related macular degeneration diseases.

• The Ocular Response Analyzer (ORA, Reichert, USA) is a device that helps to understand the structure of the cornea by measuring the corneal biomechanics and intraocular pressure (IOP). ORA gives IOP values without being affected by corneal thickness.

• After intravitreal anti-VEGF injection IOP pressures significantly increased, on the other hand, corneal hysteresis and corneal resistance factor values were significantly decreased. But, these changes were temporary.

• Our study has large case series, measuring parameter with ORA and performing all injections by the same specialists.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bekmez, S., Cakmak, H., Kocaturk, T. et al. Biomechanical properties of the cornea following intravitreal ranibizumab injection. Graefes Arch Clin Exp Ophthalmol 259, 691–696 (2021). https://doi.org/10.1007/s00417-020-05001-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-020-05001-2

Keywords

Search

Navigation