Effect of Intraocular Pressure and Anisotropy on the Optical Properties of the Cornea: A Study Using Polarization Sensitive Optical Coherence Tomography

Purpose: We hypothesize that because of the anisotropic properties of the cornea, there should be a nonuniform change in birefringence with an increase in intraocular pressure (IOP). In this in vitro study, anisotropic properties, stress distribution within the cornea, and the effect of IOP on changes in stress level were investigated. Design: Button inflation tests for deformation with polarization sensitive optical coherence tomography were used to demonstrate optical and material anisotropy on ex vivo human corneas. Methods: Inflation tests were performed on human donor corneoscleral rims. Using a turntable and hydrostatic column, each corneoscleral rim was subjected to a hydrostatic pressure of 0, 10, 15, and 20 mm Hg. At each pressure step, 4 scans at 0, 45, 90, and 135 degrees were taken by a polarization sensitive optical coherence tomography system, and the birefringence images and normal intensity-based images were recorded; images were later compiled for analysis. Results: The retardation changed with the axis of orientation (P [T <= t] 1-tailed = 0.025) and IOP (P [T <= t] 1-tailed = 0.019). Optical thickness of the cornea decreased with increasing IOP. Conclusions: The optical properties of the cornea are modified with change in IOP. This is not uniform because of distinct anisotropic properties. Anisotropic properties may unpredictably affect the optical quality of cornea during or after the surgeries. Changes in corneal birefringence can be also used as a tool for measuring the IOP of the eye.