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糖尿病对角膜生物力学参数的影响。

Effect of diabetes mellitus on biomechanical parameters of the cornea.

作者信息

Goldich Yakov, Barkana Yaniv, Gerber Yariv, Rasko Adi, Morad Yair, Harstein Morris, Avni Isaac, Zadok David

机构信息

Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel.

出版信息

J Cataract Refract Surg. 2009 Apr;35(4):715-9. doi: 10.1016/j.jcrs.2008.12.013.

Abstract

PURPOSE

To compare parameters of biomechanical response of the human cornea measured as corneal hysteresis (CH) and corneal resistance factor (CRF) in patients with diabetes mellitus and healthy control subjects.

SETTING

Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel.

METHODS

In the right eye of each participant, the CH, CRF, Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured with the Ocular Response Analyzer. Central corneal thickness (CCT) was measured by ultrasonic pachymetry and intraocular pressure by Goldmann applanation tonometry (IOP GAT). Findings were compared between the 2 groups (control and diabetic).

RESULTS

Forty diabetic patients (17 women, 23 men) and 40 healthy subjects (19 women, 21 men) were prospectively recruited. The mean CH was 9.3 mm Hg +/- 1.4 (SD) and 10.7 +/- 1.6 mm Hg and the mean CRF was 9.6 +/- 1.6 mm Hg and 10.9 +/- 1.7 mm Hg in the control group and diabetic group, respectively (both P < .0001). Diabetic corneas were significantly thicker (P = .019); the mean CCT was 530.3 +/- 35.9 microm in the control group and 548.7 +/- 33.0 microm in the diabetic group. The CH and CRF remained significantly different in multivariate analysis that included CCT. There was no statistically significant difference between the 2 groups in IOPcc, IOPg, or IOP GAT measurements.

CONCLUSIONS

Diabetes mellitus affected biomechanical parameters of the human corneas, including increased CH, CRF, and CCT. Whether this observation has implications in the clinical management and understanding of corneal ectasia and glaucoma requires further study.

摘要

目的

比较糖尿病患者与健康对照者中作为角膜滞后(CH)和角膜阻力因子(CRF)测量的人角膜生物力学反应参数。

设置

以色列泽里芬阿萨夫·哈罗费医疗中心眼科。

方法

使用眼反应分析仪测量每位参与者右眼的CH、CRF、Goldmann相关眼压(IOPg)和角膜补偿眼压(IOPcc)。通过超声测厚法测量中央角膜厚度(CCT),通过Goldmann压平眼压计测量眼压(IOP GAT)。比较两组(对照组和糖尿病组)的结果。

结果

前瞻性招募了40名糖尿病患者(17名女性,23名男性)和40名健康受试者(19名女性,21名男性)。对照组和糖尿病组的平均CH分别为9.3 mmHg±1.4(标准差)和10.7±1.6 mmHg,平均CRF分别为9.6±1.6 mmHg和10.9±1.7 mmHg(均P <.0001)。糖尿病角膜明显更厚(P = 0.019);对照组的平均CCT为530.3±35.9微米,糖尿病组为548.7±33.0微米。在纳入CCT的多变量分析中,CH和CRF仍有显著差异。两组在IOPcc、IOPg或IOP GAT测量方面无统计学显著差异。

结论

糖尿病影响人角膜的生物力学参数,包括CH、CRF增加和CCT增加。这一观察结果对角膜扩张和青光眼的临床管理及理解是否有影响需要进一步研究。

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