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The Glaucoma Pharmacological Treatment and Biomechanical Properties of the Cornea


Authors: I. Liehneová;  S. Karlovská
Authors‘ workplace: Oční oddělení KZ a. s., Masarykova nemocnice v Ústí nad Labem primářka MUDr. Ivana Liehneová
Published in: Čes. a slov. Oftal., 70, 2014, No. 5, p. 167-176
Category: Original Article

Overview

Purpose:
To evaluate and compare the impact of long-term use of intraocular pressure lowering medication on the biomechanical properties of the cornea.

Material and methods:
Group of 305 eyes of 154 patients newly diagnosed with primary open angle glaucoma (POAG, n = 68) or ocular hypertension (OH, n = 6) was enrolled in prospective cohort study. The control group was established of 80 untreated eyes of 40 patients with ocular hypertension and 80 eyes of 40 patients with no ocular pathology. Following parameters were evaluated: intraocular pressure (IOPg,IOPcc), hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT). The parameters were evaluated at baseline (untreated) and in follow up periods of 3, 6, 9 and 12 months. The same schedule was used for eyes in the control group. Eyes with POAG or OH were sorted into two groups depending on the type of applied medication: prostaglandin analogues, carboanhydrase inhibitors alone or combined with betablockers.

Results:
We did not prove any statistically significant difference in hysteresis in patients with newly diagnosed POAG (yet untreated) in comparison with normal eyes in control group (p = 0.238). We proved significantly higher values of CRF (p = 0.032) and CCT (p = 0.013) in the control group of untreated patients with ocular hypertension. This result confirms higher number of patients with stiffer and thicker corneas. Statistically significant difference of CH and CRF was proved (p < 0.0001) in eyes treated by prostaglandin analogues during follow up period. In these eyes we also demonstrated reduction of CCT (p < 0.001). We did not record any other statistically significant change in remaining followed parameters.

Conclusion:
Increase of CH and CRF can show change of biomechanical properties of the cornea after long-term use of prostaglandin analogues. The biomechanical properties of the cornea were not impacted by carboanhydrase inhibitors. Further studies are required to establish the effect of long-term use prostaglandin analogues on accuracy of IOP measurements.

Key words:
glaucoma, intraocular pressure, cornea, hysteresis, central corneal thickness


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Ophthalmology
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