Abstract
Purpose :
The purpose of this study was to investigate the relationship between glaucoma management and fornix depth. We hypothesize that the fornix will be significantly more shallow in patients with glaucoma.
Methods :
In this prospective observational study, a 3D-printed fornix depth measurement tool with 1mm gradations was used to measure the upper and lower fornices. In brief, 0.5% proparacaine hydrochloride was placed in the subject’s cul de sac, the device was inserted until the fornix was stretched to endpoint, and a photo was obtained. Fornix depth was measured digitally by assessing the position of the posterior reflection of the eyelid along the mm markings of the device.
Both eyes were measured and a randomly selected eye was included for analysis. Patients were excluded if they had any history of eyelid or ocular surface surgery or trauma outside of therapy for glaucoma. Two groups were defined, those with a known diagnosis of glaucoma and a history of treatment for such (surgical and/or medical), and those patients without a history of glaucoma (control). Medical, surgical and glaucoma history was derived from a standardized data collection instrument. The primary outcome measures were upper and lower fornix depth. The influence of glaucoma therapy on primary outcomes were additionally assessed in subgroup analysis.
Results :
The results showed a significant difference in lower lid fornix depth in the glaucoma group (8.55 ± 1.53) compared to the healthy group (9.64±1.56) (p < 0.0006). There was no difference in upper lid fornix depth between the two groups (p > 0.146). There was a significant difference in lower lid fornix depth in the surgery group (7.31±1.70) compared to patients who only received treatment with eyedrops (8.77±1.35) (p<0.0046). There was no difference in upper lid fornix depth between the two treatment groups (p>0.925).
Conclusions :
Our study found that lower lid fornix depth is significantly lower in glaucoma patients compared to healthy patients. Additionally, glaucoma patients who received surgery had a significantly shorter lower lid fornix depth than those who received medication only. Accounting for the decreased fornix depth in subsequent reconstructive and ocular surface surgery may be prudent.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.