A Critical Assessment of Friedenwald's Technique for Estimating the Coefficient of Rigidity of the Cornea
- PMID: 36237558
- PMCID: PMC9553366
- DOI: 10.1155/2022/6775064
A Critical Assessment of Friedenwald's Technique for Estimating the Coefficient of Rigidity of the Cornea
Abstract
Purpose: To determine if Friedenwald's technique for estimating the coefficient of corneal rigidity (Ko, units mmHg/μL), could differentiate between the cornea in keratoconus, normal eyes, and after crosslinking (CXL).
Methods: Two operators (1 and 2) independently measured Ko in three groups (keratoconus, normal, and post-CXL corneas), and repeated the procedure in some where their care remained unchanged and others after routine CXL (>28 days postop, epi-off treatment, 3.0 mW/cm2, 30 min). The data were subsequently used to quantify interoperator error, test-retest/intersessional reliability for estimation of Ko, the significance of intergroup differences, and the effect of CXL on Ko.
Results: The major findings were: (i) Ko values were not normally distributed; (ii) mean (±sd, 95% CI) interoperator error was -0.002 (±0.019, -0.006 to 0.003, n = 95) and the limit of agreement between the operators was ±0.039; (iii) RMS differences in the intersessional estimation of Ko values were 0.011 (operator 1) and 0.012 (operator 2); (iv) intergroup differences in Ko were not significant (p > 0.05); (v) intersessional change in Ko (y) was linearly related to Ko estimated (x) at 1st session (for operator 2 y = 1.187x-0.021, r = 0.755, n = 16, p < 0.01); and (vi) change in Ko (y 1) after CXL was linearly related to Ko (x 1) at preop (for operator 2 y 1 = 0.880x 1-0.016, r = 0.935, n = 20, p < 0.01).
Conclusion: Friedenwald's technique for estimating the Ko is prone to substantial interoperator error and intersessional differences. According to the technique, the change in Ko following CXL is on par with the expected intersessional change observed in controls.
Copyright © 2022 Larysa Tutchenko et al.
Conflict of interest statement
The authors declare that they have no conflicts of interest.
Figures
Similar articles
-
The effect of corneal crosslinking on the rigidity of the cornea estimated using a modified algorithm for the Schiøtz tonometer.Indian J Ophthalmol. 2021 Jun;69(6):1531-1536. doi: 10.4103/ijo.IJO_1820_20. Indian J Ophthalmol. 2021. PMID: 34011736 Free PMC article. Clinical Trial.
-
Are changes in visual acuity and astigmatism after corneal cross-linking (CXL) in keratoconus predictable?Graefes Arch Clin Exp Ophthalmol. 2021 Aug;259(8):2259-2268. doi: 10.1007/s00417-021-05173-5. Epub 2021 Apr 22. Graefes Arch Clin Exp Ophthalmol. 2021. PMID: 33885984
-
Transepithelial versus epithelium-off corneal crosslinking for progressive keratoconus.Cochrane Database Syst Rev. 2021 Mar 23;3(3):CD013512. doi: 10.1002/14651858.CD013512.pub2. Cochrane Database Syst Rev. 2021. PMID: 33765359 Free PMC article.
-
Efficacy and safety of transepithelial corneal collagen crosslinking surgery versus standard corneal collagen crosslinking surgery for keratoconus: a meta-analysis of randomized controlled trials.BMC Ophthalmol. 2017 Dec 28;17(1):262. doi: 10.1186/s12886-017-0657-2. BMC Ophthalmol. 2017. PMID: 29282020 Free PMC article. Review.
-
Current perspectives on corneal collagen crosslinking (CXL).Graefes Arch Clin Exp Ophthalmol. 2018 Aug;256(8):1363-1384. doi: 10.1007/s00417-018-3966-0. Epub 2018 Apr 6. Graefes Arch Clin Exp Ophthalmol. 2018. PMID: 29623463 Review.
References
-
- Schiøtz H. A new tonometer, tonometry. Norsk Mag Lægevidensk . 1905;66:597–622.
-
- Friedenwald J. S. Contribution to the theory and practice of tonometry. American Journal of Ophthalmology . 1937;20(10):985–1024. doi: 10.1016/s0002-9394(37)90425-2. - DOI
-
- Friedenwald J. S. Tonometer calibration; an attempt to remove discrepancies found in the 1954 calibration scale for Schiotz tonometers. Transactions - American Academy of Ophthalmology and Otolaryngology . 1957;61(1):108–122. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials