Johnson Thomas V, Toris Carol B, Fan Shan, Camras Carl B
Department of Ophthalmology, University of Nebraska Medical Center, Omaha, Nebraska, USA.
J Glaucoma. 2008 Mar;17(2):89-99. doi: 10.1097/IJG.0b013e31814b9938.
To determine the effect of central corneal thickness (CCT) on the efficacy of intraocular pressure (IOP)-reducing drugs in patients with ocular hypertension (OHT).
This retrospective study analyzed research records of 115 OHT patients and 97 ocular normotensive (ONT) volunteers. CCT was measured by slit-lamp pachymetry and IOP by pneumatonometry. The OHT patients were divided into Thick (>540 microm, n=52) and Thin (<or=540 microm, n=63) Cornea groups. Measurements in the OHT group were made after washout of all IOP-lowering drugs and at 1 week of treatment with latanoprost 0.005%, dorzolamide 2%, brimonidine 0.2%, apraclonidine 0.5%, pilocarpine 2%, or unoprostone 0.15% to 1 eye and vehicle contralaterally. ONT volunteers also were divided into Thick (n=34) and Thin (n=63) Cornea groups. Results were compared between groups using unpaired t tests or nonparametric Wilcoxon tests and within groups using linear regression analyses.
Baseline IOPs were not different between CCT groups of OHT patients or of ONT volunteers. After 1 week of drug treatment, IOP was significantly (P=0.02) lower in the OHT Thin Cornea group (16.0+/-3.0 mm Hg, mean+/-SD) than the OHT Thick Cornea group (17.4+/-2.8 mm Hg). There was a positive correlation between IOP and CCT (R=0.06, P=0.007) in OHT drug-treated eyes, but not OHT vehicle-treated or ONT untreated eyes. The final IOP was significantly lower in the Thin than the Thick Cornea group treated with brimonidine (P=0.02) but not with latanoprost (P=0.91).
When dosed with IOP lowering drugs, eyes with thinner corneas had lower IOPs than eyes with thicker corneas. This suggests a reduced efficacy of some glaucoma medications in ocular hypertensive patients with thick corneas.
确定中央角膜厚度（CCT）对高眼压症（OHT）患者降眼压药物疗效的影响。
这项回顾性研究分析了115例OHT患者和97例眼压正常（ONT）志愿者的研究记录。通过裂隙灯测厚法测量CCT，通过眼压计测量眼压。将OHT患者分为厚角膜组（>540微米，n = 52）和薄角膜组（≤540微米，n = 63）。OHT组在停用所有降眼压药物后以及用0.005%拉坦前列素、2%多佐胺、0.2%溴莫尼定、0.5%阿可乐定、2%毛果芸香碱或0.15%至1%的乌诺前列酮治疗1周后进行测量，对侧眼使用赋形剂。ONT志愿者也分为厚角膜组（n = 34）和薄角膜组（n = 63）。使用非配对t检验或非参数威尔科克森检验比较组间结果，并使用线性回归分析比较组内结果。
OHT患者或ONT志愿者的CCT组之间基线眼压无差异。药物治疗1周后，OHT薄角膜组（16.0±3.0毫米汞柱，平均值±标准差）的眼压显著低于OHT厚角膜组（17.4±2.8毫米汞柱）（P = 0.02）。在接受药物治疗的OHT眼中，眼压与CCT呈正相关（R = 0.06，P = 0.007），但在接受赋形剂治疗的OHT眼或未治疗的ONT眼中无此相关性。薄角膜组接受溴莫尼定治疗后的最终眼压显著低于厚角膜组（P = 0.02），但接受拉坦前列素治疗时无此差异（P = 0.91）。
使用降眼压药物时，角膜较薄的眼睛眼压低于角膜较厚的眼睛。这表明某些青光眼药物在角膜较厚的高眼压症患者中的疗效降低。
