Departments of Ophthalmology.
Innovative Visual Science, Osaka University Graduate School of Medicine.
J Glaucoma. 2021 Nov 1;30(11):996-1000. doi: 10.1097/IJG.0000000000001895.
Treatment with topical prostaglandin analogues (PGAs) induces increased corneal compliance in glaucoma eyes measured with a dynamic Scheimpflug analyzer.
The purpose of this study was to evaluate the effect of topical PGAs on the corneal biomechanical properties.
We retrospectively studied the biomechanical parameters of 31 eyes of 19 consecutive patients with glaucoma measured using a dynamic Scheimpflug analyzer (Corvis ST) before and after initiation of treatment with topical PGAs. No patients had a history of glaucoma treatment before the study and no other antiglaucoma medication was used during the study period. Nine biomechanical parameters were evaluated before and 61.6±28.5 days (range: 21 to 105 d) after initiation of the treatment. The changes in the corneal biomechanical parameters before and after treatment were analyzed using multivariable models adjusting for intraocular pressure and central corneal thickness. The Benjamini-Hochberg method was used to correct for multiple comparison.
In multivariable models, PGA treatment resulted in shorter inward applanation time (P=0.016, coefficient=-0.151) and larger deflection amplitude (P=0.023, coefficient=0.055), peak distance (P=0.042, coefficient=0.131), and deformation amplitude ratio at 1 mm (P=0.018, coefficient=0.028). These associations consistently indicated increased corneal compliance (deformability) after PGA treatment.
Topical PGAs resulted in greater corneal compliance, suggesting that the changes in the corneal biomechanical properties may lead to overestimation of the intraocular pressure-lowering effects.
应用局部前列腺素类似物(PGAs)治疗可增加青光眼患者角膜动态光学相干断层扫描仪测量的角膜顺应性。
本研究旨在评估局部 PGAs 对角膜生物力学特性的影响。
我们回顾性研究了 19 例连续青光眼患者 31 只眼的生物力学参数,这些患者在开始应用局部 PGAs 治疗前和治疗后 61.6±28.5 天(范围:21 至 105 天)使用动态光学相干断层扫描仪(Corvis ST)进行测量。在研究期间,没有患者有青光眼治疗史,也没有使用其他抗青光眼药物。在治疗前和治疗后分别评估了 9 个生物力学参数。使用多变量模型分析了治疗前后角膜生物力学参数的变化,该模型调整了眼压和中央角膜厚度。采用 Benjamini-Hochberg 方法进行多重比较校正。
在多变量模型中,PGAs 治疗导致内压平时间缩短(P=0.016,系数=-0.151)和变形幅度增大(P=0.023,系数=0.055)、峰值距离(P=0.042,系数=0.131)和 1 mm 处变形幅度比(P=0.018,系数=0.028)。这些关联一致表明 PGA 治疗后角膜顺应性增加(可变形性)。
局部 PGAs 导致角膜顺应性增加,表明角膜生物力学特性的变化可能导致眼压降低效果的高估。