局部使用前列腺素滴眼剂对角膜厚度及眼压的影响

Effects of topical application of prostaglandin eye drops on corneal thickness and intraocular pressure

目的探讨局部使用前列腺素滴眼剂对角膜厚度及眼压的影响。设计前瞻性比较性病例系列。研究对象119例原发性开角型青光眼患者。方法随机分0.004%曲伏前列素滴眼剂组(Tra组)(71眼)和0.15%酒石酸溴莫尼定滴眼剂组(Bri组)(48眼)。利用Pentacam眼前段分析仪检查用药3、6个月后两组患者的中央角膜厚度(CCT)、顶端角膜厚度(Apex CT)、最薄角膜厚度(TCT)以及距离TCT 2、4、6、8μm处的角膜厚度(CT2、CT4、CT6、CT8)变化,以及Goldmann压平眼压计校正眼压(c-IOP)值的变化。主要指标中央和周边角膜厚度、矫正眼压。结果用药前及用药6个月后Tra组CCT变化在(555.35±36.51)^(549.68±36.43)μm(P均<0.05)、Apex CT变化在(553.80±36.42)^(549.14±36.41)μm(P均<0.05)、TCT变化在(552.11±36.29)^(546.15±35.87)μm(P均<0.05)以及CT2、CT4、CT6、CT8较用药前均有相似变薄趋势(P均<0.05)。其中用药3个月CCT较用药前平均变薄(4.63±0.62)μm,6个月时平均变薄(5.67±0.64)μm。用药前与用药3、6个月的c-IOP差异均无统计学意义。Bri组用药3、6个月后角膜厚度及c-IOP差异均无统计学意义(P均>0.05)。结论局部使用前列腺素滴眼剂是导致角膜厚度变薄的潜在危险因素,而眼压矫正值无明显影响。

Objective To observe the effect of topical using of prostaglandin eye drops on the thickness of the cornea and intraocular pressure. Design Prospective comparable case-control study. Participants One hundred nineteen patients with primary open angle glaucoma. Methods Patients were randomly divided into two groups, 71 eyes in 0.004% travoprost eye drops group （Tra group） and 48 eyes in 0.15% brimonidine tartrate eye drops group （Bri group）. Central corneal thickness （CCT）, apex corneal thickness （Apex CT）, thinnest corneal thickness （TCT） and every 2 μm distant from TCT point were assessed by Pentacam Analyzer and intraoeular pressm＇e （IOP） by Goldmann applanation tonometer was corrected at the 3 and 6 months follow up. Main Outcome Measures Central and peripheral corneal thickness; corrected intraoeular pressure. Results At the last follow up, the CCT from 555.35±36.51 μm to 549.68±36.43 μm （P〈0.05）, Apex CT from 553.80±36.42μm to 549.14±36.41 μm （P〈0.05）, TCT from 552.11±36.29 μm to 546.15±35.87μm （P〈0.05） and similar to corneal thickness from TCT 2 μm, 4μm and 6 μm, 8 μm （CT2 and CT4, CT6 and CT8） in Tra group （P〈0.05）. In the 3 months, CCT was getting thinner for average 4.63±0.62μm after 3 months＇ treatment and average 5.67±0.64 pan alter 6 months＇ treatment. There were no significant differences in corrected intraocular pressure（c-IOP） at the baseline and the follow up （P〉0.05）. And no significant statistical differences was found between corneal thickness and c-IOP in Bri-group （P〉0.05）. Conclusion Topical use of prostaglandin eye drops is one of potential risk factors to make corneal thinner, despite of no effect on c-IOP.