Scheimpflug-based tomography and biomechanical assessment in pressure-induced stromal keratopathy

J Refract Surg. 2013 May;29(5):356-8. doi: 10.3928/1081597X-20130129-03. Epub 2013 Mar 20.


Purpose: To report the tomographic and biomechanical findings before and after treatment of a case of pressure-induced stromal keratopathy (PISK), which was misdiagnosed as diffuse lamellar keratitis (DLK).

Methods: A case report of a referred patient with supposed diagnosis of DLK after LASIK in the right eye. Scheimpflug-based corneal tomography and biomechanical assessment were provided by the Pentacam HR and CorVis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany).

Results: A layer of corneal opacity beneath the flap with a presumably fluid-filled interface area was observed on slit-lamp biomicroscopy. Scheimpflug image from Pentacam revealed a hyperreflective area underneath the flap interface. Goldmann applanation tonometry was 12 mm Hg, whereas CorVis intraocular pressure was 53.5 mm Hg with deformation amplitude of 0.42 mm. Two days after starting oral and topical ocular hypotensive therapy, CorVis intraocular pressure was 14 mm Hg and deformation amplitude was 1.02 mm.

Conclusions: Ocular hypertension in PISK was associated with lower deformation response, along with steepening and thickening of the cornea.

Publication types

  • Case Reports

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Biomechanical Phenomena / physiology
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Corneal Pachymetry
  • Corneal Stroma / pathology*
  • Elasticity / physiology
  • Humans
  • Intraocular Pressure / drug effects*
  • Keratomileusis, Laser In Situ*
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / drug therapy
  • Photography
  • Prednisolone / adverse effects*
  • Tomography
  • Tonometry, Ocular


  • Antihypertensive Agents
  • Prednisolone