Purpose: The aim of this study was to evaluate the association of corneal thickness on the
incidence of glaucomatous progression at individual levels of intraocular pressure.
Methods: A retrospective, noninterventional evaluation of patients with primary open-angle
glaucoma who were either stable over 5 years or had glaucomatous progression before 5
years of follow-up was performed. Each patient had central thickness corneal measurements
documented.
Results: We included 310 patients in this study. Patients with thicker (at least 0.571 mm,
n = 77) and mid-range corneas (0.511–0.570 mm, n = 177) progressed in 14% (n = 11) and 18%
(n = 31) of cases, respectively. The progression rate for patients with a mean pressure of less
than 17 mmHg in both groups was 12%–13%. In contrast, the progression rate in patients with
18 mmHg or higher was 23% and 16% in the mid-range and thick corneal groups, respectively.
In patients with thinner corneas (equal to or less than 0.510 mm, n = 56), the progression rate
was 32% (n = 18). The progression rate was 60% (12 of 20) with mean pressures of at least 18
mmHg or higher, but 18% with mean pressures equal to or less than 17 mmHg. Univariant
(P = 0.05), but not multivariant, analysis showed that corneal thickness was a risk factor for
progression.
Conclusions: This study suggests that the reduction of intraocular pressure helps to prevent
progression in patients with primary open-angle glaucoma. However, for patients with thinner
corneas, pressure reduction may potentially be of even greater importance to help avoid
glaucomatous progression. Future study should clarify potential variables associated with thin
corneas and glaucomatous progression.
