前列腺素类药物对角膜中央厚度的影响

Effect of topically administered prostamide or prostaglandin analogs on central corneal thicknes

目的 观察局部使用前列腺素类药物后中央角膜厚度的改变.方法 回顾性病例临床对照研究.对2009年1～12月在潍坊医学院临床学院眼科就诊的40例70只眼原发性开角型青光眼病人,随机分为两组,其中前列腺素组21例36只眼,噻吗心安组19例34只眼,在用药前分别测量两组的中央角膜厚度,随后按照给定的方法用药,用药随访时间为8周±7d,用药后再测量中央角膜厚度.采用配对资料的t检验进行统计分析.结果 用药前拉坦前列腺素组病人中央角膜厚度平均为（0.545±0.035）mm,曲伏前列腺素组为（0.544±0.026）mm,噻吗心安组为（0.536±0.045）mm,前列腺素组与噻吗心安组相比差异无统计学意义（P＞0.05）;用药后拉坦前列腺素组平均中央角膜厚度为（0.496±0.034）mm,曲伏前列腺素组为（0.502±0.030）mm,较用药前中央角膜厚度明显降低,差异具有统计学意义（P＜0.01）,用药后噻吗心安组中央角膜厚度为（0.542±0.036）mm,较用药前相比变化不大,差异无统计学意义（P＞0.05）.结论 局部使用前列腺素类药物后可以改变角膜基质细胞的细胞外基质,使中央角膜厚度变薄,其主要是通过调节基质金属蛋白酶来实现的.在临床实践中,局部使用前列腺素类药物治疗时,角膜变薄会造成用压平眼压计测量时低估眼压水平.

Objective To determine ifglaucoma treatment with topically administered prostamide or prostaglandin analogs could change central corneal thickness （CCT）. Methods Of 40 patients （70 eyes） were divided into two groups, 21 patients （36 eyes） treated with prostamide, 19 patients （34 eyes） with timolol. CCT was measured by ultrasound pachometry. The data of glaucomatous patients who had their CCT measured before and after monotherapy treatment were analyzed retrospectively. Follow-up time was 8 weeks ± 7 days.Paired test was used for statistical analysis. Results Initial mean± SD CCT was （0.544± 0.035 ）mm. After 8 weeks± 7 days, mean± SD CCT was （0.539± 0.036 ）mm. This reduction on CCT was statistically significant （P 〈0.001）. Conclusions Central corneal thickness measured by means of ultrasound pachometry decreases during treatment with topically administered prostamide or prostaglandin analogs.