目的：系统回顾正常人群和青光眼患者中央角膜厚度与眼压的研究资料，探讨两者之间的关联与机制。

方法：在MEDLINE数据库和Science Direct数据库搜索有关角膜中央厚度与眼压关系的研究资料。另外在南方医科大学外文科部搜索2004/2006“眼科年刊”期刊。搜索关键词包括：角膜中央厚度、眼压、青光眼、 高眼压症、剥脱青光眼、压平眼压计、厚度测量法、原发性开角青光眼、Goldmann压平眼压计。应用以下排除标准：1)非英语文献研究； 2)在2005年以前的研究； 3)案例性研究和案例点评性研究； 4)与治疗方案或外科手术技术有关的研究； 5)将青光眼与其他疾病，如糖尿病、高血压、心血管疾病来比，作为辅助变量； 6)儿童作为研究对象的研究； 7)动物作为研究对象的研究。

结果：搜索产生了13项研究，包括12个观察性研究和1个病例对照研究。与对照组相比，青光眼患者眼压水平明显升高(SMD：0.50，95% CI：0.30～0.70，Z=4.88，P<0.001)； 青光眼组患者角膜中央厚度水平有明显降低(SMD：-0.14，95% CI：-0.23～-0.05，Z=3.14，P=0.002)。Meta-回归分析结果显示年龄跟两个组之间观察到的 CCT 差异有统计学意义(P=0.025)。

结论：与正常眼组相比，青光眼组患者表现为角膜中央厚度变薄和眼压增高。

AIM: To evaluate the relationship between central corneal thickness and intraocular pressure in healthy and glaucomatous eyes of adults. To make up to date summary of the results of studies done on the association of central corneal thickness measurements and intraocular pressure measurements in Glaucoma patients and in healthy subject.

METHODS: To identify relevant studies a search of MEDLINE and Science Direct databases for studies investigating the relationship between central corneal thickness(CCT)and intraocular pressure(IOP)was conducted. The Search period was from Sep. 10^th to Oct. 28^th of 2015. Search key words included: central corneal thickness, intraocular pressure, glaucoma, ocular hypertension, exfoliative glaucoma, applanation tonometry, pachymetry, primary open angle glaucoma, Goldmann applanation tonometry. In addition, a manual search of “The Year Book of Ophthalmology” Journals 2004 to 2006 Issues in the Southern Medical University Library English language section was done. The following exclusion criteria applied: 1)non-English media studies; 2)studies done before 2005; 3)case series and case reviews; 4)studies involving treatment protocols or surgical techniques; 5)studies comparing glaucomatous eyes with other conditions such as diabetes, hypertension or cardiovascular disease as secondary variables; 6)studies with children as study subjects; 7)studies with animal subjects.

RESULTS: There were 12 observational studies and 1 case control study included. Compared to control subjects, patients had significantly increased IOP(SMD: 0.50, 95% CI: 0.30～0.70, Z=4.88, P<0.001). Compared to control subjects, patients had significantly decreased CCT levels(SMD: -0.14, 95% CI: -0.23～-0.05, Z=3.14, P=0.002). Meta-regression revealed that mean-age(P=0.025)was found to have a statistically significant relation to the observed CCT difference between glaucomatous eyes and controls.

CONCLUSION: It has been established that glaucomatous eyes tend to have thinner CCT and higher IOP compared to normal eyes.

国家自然科学基金(No. 81170887); 南方医科大学南方医院横向课题基金(No. G201202)