中央角膜厚度对压平眼压计测量值的影响  

The influence of the central corneal thickness on the intraocular pressure value measured by Goldmann applanation tonometer

作　　者：段宣初[1] 吴勤[1] 蒋幼芹[1] 卿国平[1] 江冰[1] 石晶明[1] 

机构地区：[1]中南大学湘雅二医院眼科,长沙410011

出　　处：《中国实用眼科杂志》2004年第10期778-782,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的　采用非接触式角膜内皮镜测量高眼压症与临床常见类型青光眼患者的中央角膜厚度centralcornealthickness (CCT) ,并与正常人CCT平均值比较 ,探讨CCT对青光眼诊断、分类与治疗的指导意义。方法　采用KONAN非接触式角膜内皮镜测量中央角膜厚度 ,Goldmann压平眼压计测量眼内压 (IOP)。将 3 9例 5 2眼原发性开角型青光眼 (POAG) ,3 2例 45眼慢性闭角型青光眼(CACG) ,18例 2 9眼高眼压症眼 (OHT) ,15例 2 4眼正常眼压性青光眼 (NTG) ,3 4例 66眼可疑开角型青光眼 (GS)的CCT和IOP值与 173例 3 2 2眼正常眼进行比较研究。所有资料输入计算机后在Windows操作环境下使用SPSS10 0统计软件进行统计分析。结果　平均CCT值比较 :高眼压症(OHT)眼 (60 0 2 1± 2 4 2 0 μm) >POAG眼 (5 74 3 7± 3 1 92 μm) >正常对照眼 (5 5 4 78± 3 2 61μm )>NTG眼 (5 2 8 43± 3 6 40 μm)。OHT、NTG、POAG眼与正常眼的CCT值有差异 (F =9 62 9,P =0 0 0 0 ) ,CACG眼与POAG及正常眼CCT值均无差异 (P =0 119)。GS眼CCT值 (5 64 72±3 1 96μm)较正常眼厚。CCT与IOP成直线正相关 ,眼压测量值的校正公式为 :眼压校正值(mmHg) =-(测得的角膜厚度 μm -5 5 5 μm )× (1/2 4)。IOP经CCT校正后 ,OHT眼平均高估1 89mHg 。Objective The central corneal thickness(CCT)measured by non-contact specular microscope.To discuss the effect of the CCT on the measured value of the intraocular pressure(IOP)by Goldmann applanation tonometer,then establish a formula to expound the relation between the CCT and the IOP through measuring normal eyes,ocular hypertension and different types of glaucomatous eyes,and find out the importance of the CCT in the diagnosis and treatment of glaucoma.Methods The CCT was determined by the KONAN non-contact specular microscope and the IOP was measured by Goldmann applanation tonometer.39 patients(52 eyes)with primary open angle glaucoma(POAG),32 patients(45 eyes)with chronic angle-closure glaucoma(CACG),18 cases(29eyes)with ocular hypertension(OHT),15 patients(24 eyes)with normal tension glaucoma(NTG)and 34 open angle glaucoma suspect(GS,66eyes)were compared with the normal control subjects(173 cases,322 eyes).The statistical analysis were performed using PC SPSS version 10 0 under Windows System.Results Measured by the non-contact specular microscope,the mean value of the CCT in normal eyes is 554 61±32 78μm.The comparison of the value of the CCT in different groups:OHT(600 21±24 20μm)>POAG(574 37±31 92μm)>normal eyes(554 61±32 78μm)>NTG(528 43±36 40μm).The CCT in GS eyes(564 72±31 96μm)was thicker than normal eyes.A positive linear regression existing between the CCT and the IOP.The corrected formula of the IOP is:the corrected IOP(mmHg)=-(the measured CCTμm-555μm)×(1/24).Being corrected,OHT has an overestimation of 1 88mmHg,NTG has a underestimation of 1 1mmHg.As well,being corrected by CCT,13 5% POAG could be reclassified as having NTG,34 5% OHT could be reclassified as having normal eyes,and 16 7% NTG could be reclassified as having POAG.Conclusions The CCT can be accurately measured by non-contact specular microscope.There is a positive correlation between the CCT and the IOP.The IOP increased every 1 mmHg with the CCT 24μm thicker.The CCT of OHT is thicker than that

关 键 词：CCT NTG 诊断 POAG 正常眼 中央角膜厚度 IOP 直线 结论 常见类型 

分 类 号：R775[医药卫生—眼科] R772.2[医药卫生—临床医学]