Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Air-pulse Corneal Applanation Signal Curve Parameters for Characterization of Astigmatic Corneas

Trivizki, Omer MD; Shahar, Jonathan MD; Levinger, Samuel MD; Levinger, Eliya MD

doi: 10.1097/ICO.0000000000000153
Clinical Science

Purpose: The aim of this study was to test the 42 parameters of the ocular response analyzer for distinguishing between the biomechanical properties of emmetropic eyes with normal topography and eyes with moderate-to-high with-the-rule astigmatism (WTA) and against-the-rule astigmatism (ATA) that have symmetric bowtie topography.

Methods: This retrospective case series study included 37 patients (37 studied eyes) with WTA astigmatism and 35 patients (35 studied eyes) with ATA astigmatism. The control group consisted of 70 patients with emmetropia (70 studied eyes) with normal topography. We first tested correlations of the parameters that describe the applanation curve during ocular response analyzer measurements with the maximum keratometry values and the corneal thickness in all 3 groups. We then evaluated the significant parameters among them in search of any group differences in the biomechanical properties of the cornea.

Results: Fifteen parameters correlated with Kmax reading values or corneal thickness values. The correlation coefficients (r) were low. The best correlated parameters were p1area, p2area, h1, dive1, p2area1, h11, h2, and h21. The ATA group had the highest number of parameters (n = 6) with significant differences compared with the control group. Only p2area was predictive for ATA. In contrast, the WTA group had only 1 parameter (p2area1) that was found to be significantly different compared with the control group.

Conclusions: Some of the new waveform parameters can distinguish between patients with ATA and WTA and normal topography patterns and may delineate the differences in biomechanical properties between these groups that may predict the risk of corneal ectasia after laser in situ keratomileusis.

*Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; and

Enaim Refractive Surgery Center, Jerusalem, Israel.

Reprints: Omer Trivizki, MD, Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv 6423906, Israel (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received January 26, 2014

Accepted April 09, 2014

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.