Shih Carolyn Y, Graff Zivin Joshua S, Trokel Stephen L, Tsai James C
Edward S. Harkness Eye Institute, Department of Ophthalmology, College of Physicians and Surgeons, Columbia University, 635 W 168th Street, New York, NY 10032, USA.
Arch Ophthalmol. 2004 Sep;122(9):1270-5. doi: 10.1001/archopht.122.9.1270.
To evaluate the effect of central corneal thickness determination on the clinical management of patients with glaucoma and glaucoma suspect.
A cross-sectional retrospective study was performed on 188 consecutive patients. Mean ultrasound pachymetry measurements of central corneal thickness and corresponding Goldmann applanation tonometry measurements were obtained. Intraocular pressures (IOPs) were corrected using linear and mathematical (Orssengo-Pye) algorithms. Measurement-significant outcomes were defined as an IOP adjustment of 1.5 mm Hg or greater and outcomes-significant results as an IOP adjustment of 3.0 mm Hg or greater. Changes in therapy such as the use of eyedrops and addition or cancellation of laser therapy or surgery were then noted for those individuals with measurement- or outcomes-significant changes.
Using the linear correction scale, 105 (55.9%) of 188 patients had at least a measurement-significant adjustment in their IOP measurements: 67 (35.6%) had adjustments between 1.5 and 3.0 mm Hg, while 38 (20.2%) had an outcomes-significant IOP adjustment (> or =3.0 mm Hg). Among the 188 patients, 16 (8.5%) had a change in eyedrop therapy, 4 (2.1%) had a change regarding laser therapy, and 6 (3.2%) had a change in the decision regarding glaucoma surgery. Using the exponential correction (Orssengo-Pye) scale, similar percentages were obtained.
Pachymetry-measured central corneal thickness has a significant effect on the clinical management of patients with glaucoma and glaucoma suspect.
评估中央角膜厚度测定对青光眼及青光眼疑似患者临床治疗的影响。
对188例连续患者进行横断面回顾性研究。获取中央角膜厚度的平均超声测厚测量值及相应的Goldmann压平眼压测量值。使用线性和数学（Orssengo - Pye）算法校正眼内压（IOP）。测量显著结果定义为IOP调整1.5 mmHg或更大，结果显著结果定义为IOP调整3.0 mmHg或更大。然后记录那些测量或结果有显著变化的个体在治疗方面的变化，如滴眼液的使用、激光治疗或手术的增加或取消。
使用线性校正量表，188例患者中有105例（55.9%）在IOP测量中至少有测量显著调整：67例（35.6%）调整幅度在1.5至3.0 mmHg之间，而38例（20.2%）有结果显著的IOP调整（≥3.0 mmHg）。在188例患者中，16例（8.5%）在滴眼液治疗方面有变化，4例（2.1%）在激光治疗方面有变化，6例（3.2%）在青光眼手术决策方面有变化。使用指数校正（Orssengo - Pye）量表，得到了相似的百分比。
测厚法测量的中央角膜厚度对青光眼及青光眼疑似患者的临床治疗有显著影响。
