目的：比较长期居住于西藏自治区不同海拔藏族人群的眼压及眼前节生物学参数差异，探讨高海拔环境对眼部特征的影响。

方法：回顾性横断面研究。收集2019年9月至2021年10月于西藏自治区人民医院就诊的藏族患者资料。根据长居地海拔分为较高海拔组(2 500-3 750 m)和超高海拔组(>3 750 m)。选取最佳矫正视力较好眼，记录两组的眼压、屈光度及眼前节生物测量参数\〖角膜横径(WTW)、中央角膜厚度(CCT)、前房深度(ACD)、晶状体厚度(LT)、眼轴长度(AL)\〗，并进行比较。

结果：共纳入藏族患者43例43眼，其中男23例，女20例，年龄57.88±13.90岁。超高海拔组19例19眼，较高海拔组24例24眼。超高海拔组眼压为11.79±1.72 mmHg，显著低于较高海拔组(13.44±2.43 mmHg)(P=0.019)。超高海拔组CCT为482.70±23.76 μm，显著薄于较高海拔组(503.00±31.09 μm)(P=0.012)； 超高海拔组AL为22.96±0.96 mm，显著短于较高海拔组(23.64±1.10 mm)(P=0.020)。两组间WTW、ACD、LT及屈光度无差异(均P>0.05)。

结论：在西藏自治区藏族人群中，随着居住地海拔的升高，眼压测量值显著降低，CCT变薄，AL缩短。这种形态学改变提示眼球在超高海拔环境下可能存在适应性重塑，较薄的角膜可能是导致眼压测量值偏低的重要因素。

METHODS:This was a retrospective cross-sectional study. Data were collected from Tibetan patients who visited the People's Hospital of Xizang Autonomous Region from September 2019 to October 2021. Participants were divided into two groups based on their permanent residence altitude: a higher altitude group(2 500-3 750 m)and a very high-altitude group(>3 750 m). The eye with better best corrected visual acuity was selected for each participant. Intraocular pressure, refractive error, and anterior segment biometric measurements \〖white-to-white corneal diameter(WTW), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), axial length(AL)\〗 were recorded and compared between the two groups.

RESULTS: A total of 43 Tibetan patients(43 eyes)were enrolled in this study, comprising 23 males and 20 females, with a mean age of 57.88±13.90 y. There were 19 patients(19 eyes)in the very high-altitude group and 24 patients(24 eyes)in the higher altitude group. The mean intraocular pressure in the very high-altitude group was 11.79±1.72 mmHg, which was significantly lower than 13.44±2.43 mmHg in the higher altitude group(P=0.019). CCT in the very high-altitude group was 482.70±23.76 μm, significantly thinner than 503.00±31.09 μm in the higher altitude group(P=0.012). AL in the very high-altitude group was 22.96±0.96 mm, significantly shorter than 23.64±1.10 mm in the higher altitude group(P=0.020). No statistically significant differences were found between the two groups in WTW, ACD, LT, or refractive error(all P>0.05).

CONCLUSION:Among the Tibetan population in Xizang autonomous region, as the altitude of residence increases, intraocular pressure significantly decreases, CCT becomes thinner and AL shortens. These morphological changes suggest possible adaptive remodelling of the eye in very high-altitude environments, and a thinner cornea may be an important factor contributing to the lower measured intraocular pressure values.