Cohen Elisabeth J
Department of Ophthalmology, Jefferson Medical College, Thomas Jefferson University, and the Cornea Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:282-99.
To test the hypothesis that keratoconus and pellucid patients who have glaucoma or are suspected of having glaucoma have lower corneal hysteresis (CH) and/or corneal resistance factor (CRF) measurements compared to controls.
A prospective study at a tertiary eye center of keratoconus and pellucid patients with glaucoma or suspected of having glaucoma, and age-matched keratoconus and pellucid controls, was performed. After informed consent was obtained, corneal topography, ocular response analyzer measurements, pachymetry, intraocular pressure, A-scan measurements, Humphrey visual fields (VFs), and disc photos were done. Analyses compared cases to controls on primary (CH and CRF) and secondary variables. Disc photos and VFs were rated in a masked fashion.
The mean CH (8.2, SD=1.6, vs 8.3, SD=1.5) and CRF (7.3, SD=2.0, vs 6.9, SD=2.1) were low and did not differ significantly between 20 study patients (29 eyes) and 40 control patients (61 eyes), respectively. CH had a negative, significant correlation with maximum corneal curvature by topography (P < .002) and positive, significant correlation with central corneal thickness (P < .003). The mean cup-disc ratio was larger among cases than controls (0.54, SD=0.20, vs 0.38, SD=0.20; P = .003). VFs were suggestive of glaucoma more often among the study eyes than controls (11 of 29, 37.9%, vs 8 of 60, 13.3%; P =.019).
CH was low in study and control patients and was correlated with severity of keratoconus/pellucid, but not with glaucoma/suspected glaucoma or control status. Evidence of glaucoma was more common in study eyes than controls, but was present in both.
检验圆锥角膜和透明角膜患者中患有青光眼或疑似患有青光眼者相比对照组角膜滞后（CH）和/或角膜阻力因子（CRF）测量值更低这一假设。
在一家三级眼科中心对患有青光眼或疑似患有青光眼的圆锥角膜和透明角膜患者以及年龄匹配的圆锥角膜和透明角膜对照者进行了一项前瞻性研究。在获得知情同意后，进行了角膜地形图、眼反应分析仪测量、角膜厚度测量、眼压测量、A超测量、汉弗莱视野检查（VFs）以及视盘照相。分析比较了病例组和对照组的主要（CH和CRF）及次要变量。视盘照相和VFs以盲法进行评级。
20例研究患者（29只眼）和40例对照患者（61只眼）的平均CH（分别为8.2，标准差 = 1.6，与8.3，标准差 = 1.5）和CRF（分别为7.3，标准差 = 2.0，与6.9，标准差 = 2.1）较低且无显著差异。CH与地形图测量的最大角膜曲率呈负相关且具有显著性（P < .002），与中央角膜厚度呈正相关且具有显著性（P < .003）。病例组的平均杯盘比大于对照组（0.54，标准差 = 0.20，与0.38，标准差 = 0.20；P = .003）。研究眼比对照眼中更常出现提示青光眼的VFs（29只眼中有11只，37.9%，与60只眼中有8只，13.3%；P = .019）。
研究患者和对照患者的CH均较低，且与圆锥角膜/透明角膜的严重程度相关，但与青光眼/疑似青光眼或对照状态无关。研究眼中青光眼的证据比对照眼中更常见，但两者均有存在。
