Xu Yunzhi, Ye Yiming, Chen Zidong, Xu Jiangang, Yang Yangfan, Zhang Yuning, Liu Pingping, Fan Yanmei, Chong Iok Tong, Yu Keming, Lam David C C, Yu Minbin
From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases (Y.X., Y.Y., Z.C., J.X., Y.Y., Y.Z., P.L., Y.F., K.Y., M.Y.), Guangzhou, China.
Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology (I.T.C., D.C.C.L.), Kowloon, Hong Kong.
Am J Ophthalmol. 2025 Jan;269:216-225. doi: 10.1016/j.ajo.2024.08.027. Epub 2024 Aug 30.
To investigate the relationship between intraocular pressure (IOP) changes and corneal biomechanical properties, determine the quantitative relationship between IOP changes and corneal biomechanical properties in patients with glaucoma and observe the differences among different types of glaucoma when the effects of high-level IOP were excluded.
Prospective clinical cohort study.
Setting: Institutional.
Treatment-naive patients with primary open-angle glaucoma or ocular hypertension (OHT) were included.
IOP was measured using a Goldmann applanation tonometer. Corneal biomechanics were evaluated using a corneal indentation device and corneal visualization Scheimpflug technology. Medication therapy was used for IOP reduction. Repeated measurements were taken at the baseline visit and each week thereafter within a month. Paired t tests were used to compare IOP and corneal biomechanical metrics before and after IOP-lowering therapy. One-way analysis of variance was employed to investigate potential differences across groups, with a Bonferroni post hoc correction administered for multiple intergroup comparisons.
Corneal biomechanical parameters following IOP changes.
Eighty-one participants (mean age, 41.63 ± 17.33 years) were included in this study. The cohort comprised 20 patients with normal-tension glaucoma (NTG), 47 with high-tension glaucoma (HTG), and 14 with OHT. The baseline corneal stiffness (88.58 ± 18.30 N/m) and corneal modulus (0.71 ± 0.16 MPa) were greater than the post-IOP reduction values (67.15 ± 9.24 N/m and 0.54 ± 0.08 MPa, respectively; P < .001). The relationships between changes in IOP and changes in corneal biomechanical parameters were Δ corneal stiffness = 2.06ΔIOP+6.47 (P < .001) and Δ corneal modulus = 0.017ΔIOP+0.051 (P < .001). After IOP reduction, the mean corneal stiffness at the 4th week in the NTG group was significantly lower (60.97 ± 6.36 N/m) than that in the HTG (67.25 ± 9.01 N/m) and OHT (75.62 ± 6.52 N/m, P < .001) groups. Additionally, the stiffness of HTG patients was lower than that of OHT patients (P = .003).
Changes in IOP have an impact on corneal biomechanical parameters. Decreases in corneal stiffness and modulus were observed after IOP reduction. When the effect of high-level IOP was excluded, corneal biomechanics varied according to the type of glaucoma. The HTG corneas were softer than the OHT corneas, and the NTG corneas were even softer.
研究眼压（IOP）变化与角膜生物力学特性之间的关系，确定青光眼患者眼压变化与角膜生物力学特性之间的定量关系，并在排除高眼压影响后观察不同类型青光眼之间的差异。
前瞻性临床队列研究。
研究机构。
纳入未经治疗的原发性开角型青光眼或高眼压症（OHT）患者。
使用Goldmann压平眼压计测量眼压。使用角膜压痕装置和角膜可视化Scheimpflug技术评估角膜生物力学。采用药物治疗降低眼压。在基线访视时以及此后一个月内每周进行重复测量。配对t检验用于比较降眼压治疗前后的眼压和角膜生物力学指标。采用单因素方差分析研究各组之间的潜在差异，并对多个组间比较进行Bonferroni事后校正。
眼压变化后的角膜生物力学参数。
本研究纳入81名参与者（平均年龄41.63±17.33岁）。该队列包括20例正常眼压性青光眼（NTG）患者、47例高眼压性青光眼（HTG）患者和14例高眼压症患者。基线角膜硬度（88.58±18.30N/m）和角膜模量（0.71±0.16MPa）大于降眼压后的数值（分别为67.15±9.24N/m和0.54±0.08MPa；P<.001）。眼压变化与角膜生物力学参数变化之间的关系为Δ角膜硬度=2.06×Δ眼压+6.47（P<.001）和Δ角膜模量=0.017×Δ眼压+0.051（P<.001）。降眼压后，NTG组第4周的平均角膜硬度（60.97±6.36N/m）显著低于HTG组（67.25±9.01N/m）和OHT组（75.62±6.52N/m，P<.001）。此外，HTG患者的角膜硬度低于OHT患者（P=.003）。
眼压变化对角膜生物力学参数有影响。降眼压后观察到角膜硬度和模量降低。在排除高眼压的影响后，角膜生物力学因青光眼类型而异。HTG角膜比OHT角膜更软，NTG角膜更软。
