ABSTRACT
Purpose: To compare the central corneal thickness (CCT) measured by non-contact tono-pachymeter [Tonopachy (TP)] with the gold standard ultrasound pachymetry (UP) in normal children and in children with refractive error. Methods: This cross-sectional study involved 95 normal children (190 eyes) and 123 children with refractive error (246 eyes), a total of 218 children (436 eyes) aged 7-15 years. After refraction and complete ophthalmic evaluation, axial length was measured with IOLMaster 700, CCT was measured with TP followed by UP. The correlation between the CCT measurements obtained with the two methods was analysed by Intraclass correlation coefficient (ICC) and the limits of agreement were assessed with Bland-Altman analysis plot. Results: Mean CCT measured with TP was 537.46 ± 36.41 µm and by UP was 537.17 ± 39.80 µm in normal children (P = 0.79) and in refractive error group, the mean CCT was 533.50 ± 34.91 µm by TP and 531.60 ± 36.30 µm by UP (P = 0.04). The 95% limits of agreement between TP and UP ranged from -19.2 to + 21.6 µm (mean = 1.20) for total children, -20.8 to + 21.4 µm (mean = 0.29) for normal group and -18.0 to + 21.8 µm (mean = 1.90) for refractive error group. ICC for CCT measurement between TP and UP was 0.980 for total children and refractive error group and 0.981 for normal group. Conclusion: The CCT measurement obtained by TP showed an excellent agreement with UP. Hence non-contact TP can be used to assess CCT in children above seven years of age.
Subject(s)
Cornea , Refractive Errors , Child , Cornea/diagnostic imaging , Corneal Pachymetry , Cross-Sectional Studies , Humans , Refractive Errors/diagnosis , Reproducibility of Results , UltrasonographyABSTRACT
PURPOSE: To compare 0.1% nepafenac, a topical nonsteroidal anti-inflammatory drop, with 1% prednisolone acetate in controlling inflammation after neodymium:yttrium-aluminum-garnet laser peripheral iridotomy (LPI) in primary angle-closure suspects (PACS). DESIGN: Randomized controlled trial. PARTICIPANTS: One hundred fifty-two PACS undergoing bilateral LPI. METHODS: Patients were randomized to 0.1% nepafenac or 1% prednisolone acetate eye drops in both eyes. Medications were given 4 times daily for 7 days, then twice daily for additional 7 days. Investigators were masked to the type of medication. Right eyes in patients with bilateral PACS and the PACS eye in asymmetrical disease (primary angle closure in fellow eye) were analyzed. MAIN OUTCOME MEASURES: Noninferior control of inflammation, defined as absence of cell in the anterior chamber at 2 weeks and absence of rebound iritis with medication discontinuation, was the primary outcome, whereas difference in the rise in intraocular pressure (IOP) was a secondary outcome. RESULTS: Both groups were comparable in baseline characteristics, including IOP and total laser energy. Nepafenac was noninferior to prednisolone with regard to inflammation control, with 1 nepafenac-treated eye (1.3%) not meeting the primary end point because of 1+ anterior chamber cell at 2 weeks and 4 prednisolone-treated eyes (5.4%) failing to meet the primary end point because of rebound iritis (P < 0.001). A greater increase in IOP from baseline to 2 weeks was observed in the prednisolone group compared with the nepafenac group (+2.6 mmHg vs. +0.6 mmHg; P = 0.004), although at 4 weeks, IOP was not significantly different than baseline in either group (P > 0.05 for both). Two weeks after LPI, 3 nepafenac-treated eyes and 10 prednisolone-treated eyes demonstrated a 6- to 15-mmHg IOP elevation from baseline (P = 0.10), whereas 2 prednisolone-treated eyes and no nepafenac-treated eyes showed IOP elevation of more than 15 mmHg (P = 0.20). Four weeks after LPI, more prednisolone-treated eyes showed IOP elevation of 6 to 15 mmHg as compared with nepafenac-treated eyes (6 eyes vs. 1 eye; P = 0.04); no eyes showed IOP elevation of more than 15 mmHg. CONCLUSIONS: Nepafenac was noninferior to prednisolone in controlling inflammation after LPI in PACS.
