Domke N, Hager A, Wiegand W
Abteilung für Augenheilkunde, Klinikum Nord-Heidberg, Tangstedter Landstrasse 400, 22417 Hamburg.
Ophthalmologe. 2006 Jul;103(7):583-7. doi: 10.1007/s00347-006-1364-1.
Corneal thickness and deformation seem to have a considerable influence on intraocular pressure measurement. Due to differences in the corneal deformation in either non-contact tonometry or applanation tonometry, both methods should be compared in the same patient group depending on central corneal thickness.
In 106 eyes of 55 patients (18 males, 37 females, age 17-89 years, mean 63.3 years) with glaucoma and central corneal thickness between 409 and 644 microm (Orbscan II pachymetry) intraocular pressure was measured in each eye with non-contact tonometry (Reichert AT550) and 30 min later with Goldman applanation tonometry.
Non-contact tonometry as well as applanation tonometry showed a positive correlation between measured intraocular pressure and corneal thickness. The steepness of the line of regression was 0.33 mmHg per 10 microm of corneal thickness in non-contact tonometry and 0.17 mmHg per 10 microm of corneal thickness in applanation tonometry.
Independently of the large differences in individual pressure measurements between non-contact tonometry and applanation tonometry, we found higher IOP values with non-contact tonometry in thicker corneas as compared with applanation tonometry. In thinner corneas there was a better correspondence between both methods. Thus, it seems very likely that corneal rigidity increases with corneal thickness.
角膜厚度和变形似乎对眼压测量有相当大的影响。由于非接触眼压测量法或压平眼压测量法中角膜变形存在差异,两种方法应在同一患者组中根据中央角膜厚度进行比较。
对55例患者(18例男性,37例女性,年龄17 - 89岁,平均63.3岁)的106只眼睛进行研究,这些患者患有青光眼,中央角膜厚度在409至644微米之间(Orbscan II测厚仪测量)。每只眼睛先用非接触眼压测量法(Reichert AT550)测量眼压,30分钟后再用戈德曼压平眼压测量法测量。
非接触眼压测量法和压平眼压测量法均显示所测眼压与角膜厚度呈正相关。非接触眼压测量法中回归直线的斜率为每10微米角膜厚度0.33 mmHg,压平眼压测量法中为每10微米角膜厚度0.17 mmHg。
尽管非接触眼压测量法和压平眼压测量法在个体眼压测量上存在很大差异,但我们发现,与压平眼压测量法相比,角膜较厚时非接触眼压测量法测得的眼压值更高。角膜较薄时,两种方法的一致性更好。因此,角膜硬度似乎很可能随角膜厚度增加而增加。