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The article¹ and editorial² concerning the correlation of intraocular pressure with other clinical factors neglect the influence of corneal thickness on pressure measurements. In this study, the patients with low-pressure glaucoma may include some with abnormally thin corneas,³ whereas others in the primary open-angle glaucoma group may have thick corneas and only seem to have elevated pressures.⁴ Reduction in apparent tonometry values after refractive surgery is recognized.^5-6 It appears that any surgical manipulation of the cornea, even without a reduction in thickness, affects subsequent measurements.⁷ Patients with progressive neuroretinal rim loss despite surgical reduction in intraocular pressure may actually have less rigid corneas. Thinning of the peripheral cornea and disruption of stromal fibers, which are inevitable consequences of filtering procedures, may contribute to an apparent normalization of intraocular pressure.Therefore, the contributions of this potentially important article are diminished by the failure to include corneal thickness factors in the assessment of . . . [Full Text of this Article]

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