Clinical Significance of Central Corneal Thickness in the Managementof Glaucoma

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Abstract
Over the past 50 years, central corneal thickness (CCT) measurementhas been an important variable in the assessment of intraocular pressure (IOP)values in patients undergoing refractive and corneal transplant surgery, aswell as in contact lens wearers.1 Studies byEhlers and Hansen2 and Whitacre et al3 stressed that IOP measurements should be adjustedfor CCT. However, the incorporation of CCT-adjusted IOP measurements intodaily clinical practice was limited until recently, when the Ocular HypertensionTreatment Study4 reported that CCT was a strongpredictor for the development of primary open-angle glaucoma in patients withocular hypertension. In particular, this study demonstrated thatsubjects with decreased CCT measurements had an increased risk of developing primaryopen-angle glaucoma (for every 40-µm decrease in CCT, the relative riskwas 1.71). Moreover, individuals with CCTs of 555 µm or less had a 3times greater risk of developing glaucoma compared with patients with CCTsof greater than 588 µm. Moreover, with millions of individuals havingundergone laser in situ keratomileusis surgery,5,6 thereis a growing concern that the process of removing corneal tissue during thissurgery (with resulting thinner corneas) will lead to an increased difficultyin diagnosing glaucoma, because this surgery tends to alter IOP measurementsand may in turn require greater emphasis on the assessment of the optic discand visual fields for the diagnosis and treatment of glaucoma.7,8

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