1
|
Parikh SR, Parikh RS. Clinical implication of recent randomized control trial in primary angle-closure disease management. Indian J Ophthalmol 2022; 70:2825-2834. [PMID: 35918922 PMCID: PMC9672731 DOI: 10.4103/ijo.ijo_1807_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Blindness due to primary angle-closure glaucoma (PACG) can be reduced significantly if the ongoing angle-closure process is arrested at an early stage. Various treatments such as laser peripheral iridotomy (LPI), iridoplasty, and clear lens extraction (CLE) have been advocated as first-line therapy for primary angle-closure (PAC), PACG, and high-risk cases of primary angle-closure suspect (PACS). EAGLE study, propagated the effectiveness of CLE over LPI for the management of primary angle closure and have sparked controversy regarding the role of LPI as a first line procedure. Randomized controlled trials (RCT), systematic reviews, and meta-analyses of RCTs done on the same question provide us with a solid base for creating guidelines/modules for our day-to-day clinical practice. A systematic review was conducted, searching several databases, including PubMed, Cochrane Library, EMBASE, and ClinicalTrials.gov, for the last 16 years (January 2005–December 2021) for RCTs with data published related to primary angle-closure disease (PACD). The search strategy included the following terms: “Primary Angle Closure disease,” “Primary Angle Closure Glaucoma,” “Primary Angle Closure,” “Primary Angle Closure Suspect,” “clear lens extraction,” “laser iridotomy,” “laser peripheral iridotomy,” “argon laser peripheral iridoplasty,” “selective laser trabeculoplasty,” “trabeculectomy,” “randomized control trial,” and “meta-analysis of randomized control trial.” In this review, we will discuss recently published RCTs (within the last 16 years) for the management of PACD and their clinical implications in day-to-day practice.
Collapse
Affiliation(s)
- Shefali R Parikh
- Shreeji Eye Clinic and Palak's Glaucoma Care Centre, Mumbai, Maharashtra, India
| | - Rajul S Parikh
- Shreeji Eye Clinic and Palak's Glaucoma Care Centre, Mumbai, Maharashtra, India
| |
Collapse
|
2
|
Moussa IR, Kassem RR, Edris NA, Khalil DH. Normal intraocular pressure in Egyptian children and meta-analysis. Eye (Lond) 2022; 36:1266-1273. [PMID: 34145417 PMCID: PMC9151725 DOI: 10.1038/s41433-021-01633-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/22/2021] [Accepted: 06/10/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the normal intraocular pressure in a sample of Egyptian children 0-12 years of age, and compare it to that recorded in previous studies. METHODS This is a prospective cross-sectional study, including 345 eyes. All children underwent complete history taking and ophthalmic examination. Any glaucomatous patients or glaucoma suspects were excluded. Intraocular pressure was measured using Haag Streit Perkins M2 handheld applanation tonometer under topical or general anaesthesia. Three readings were recorded for each eye and the average was calculated. Central corneal thickness was measured, using handheld pachymeter (Pachmate 2), whenever possible. RESULTS The study included 345 eyes of 187 children (101 males and 86 females), aged 2 months to 12 years (mean: 5.69 ± 3.42 years). The recorded IOP was 5-20 mm Hg (mean: 11.5 ± 2.34 mm Hg). Central corneal thickness was 469-742 μm (mean: 564.8 ± 42.72 μm). The mean recorded intraocular pressure showed positive correlation with increased age (p = 0.026) and increased central corneal thickness (p = 0.037), with a difference of 1 mm Hg for every 100-μm change in central corneal thickness. The mean IOP was significantly lower than that recorded by most previous studies. A detailed comparative analysis is presented comparing our findings with other studies including grouped analysis, by country, ethnicity and tonometers used. CONCLUSIONS The mean IOP in a group of normal Egyptian children was 11.5 ± 2.34 mm Hg, with positive correlation to age and central corneal thickness. This mean intraocular pressure was lower than that previously reported in any other population.
Collapse
Affiliation(s)
| | | | - Noha Ahmed Edris
- grid.7776.10000 0004 0639 9286Ophthalmic Department, Cairo University, Cairo, Egypt
| | - Dalia Hamed Khalil
- grid.7776.10000 0004 0639 9286Ophthalmic Department, Cairo University, Cairo, Egypt
| |
Collapse
|
3
|
Lubbad A, Oluwatoba-Popoola I, Haar M, Framme C, Bajor A. The influence of corneal density and thickness on tonometry measurement with goldmann applanation, non-contact and iCare tonometry methods. Int Ophthalmol 2022; 42:2167-2174. [PMID: 35023013 PMCID: PMC9287215 DOI: 10.1007/s10792-022-02216-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of corneal density and thickness on the accuracy of tonometry readings obtained via three most used techniques. METHOD Intraocular pressures of 45 patients' right eyes were measured using Goldmann Applanation, iCare, and non-contact tonometry methods. Corneal parameters were obtained using the Pentacam Camera System. Data obtained were analyzed using Paired t Test, Pearson's correlation coefficient, multiple linear regression analysis, and Bland-Altman plots. RESULTS The mean corneal thickness was 545.4 ± 3.93 μm. The mean corneal density of total, stromal, 0-2 mm, and 2-6 mm zones were 27.85 ± 6.23 GSU, 24.61 ± 6.05 GSU, 20.76 ± 2.96 GSU, and 20.81 ± 3.51 GSU respectively. IOP readings had a statistically significant correlation with corneal stromal thickness, as well as with total and stromal density. The stromal density, however, showed higher correlation with the three tonometry methods than did the total density (iCare: - .482 (0.001) stromal density versus- .464 (0.001) total density, NCT: - .376 (0.011) versus - .353 (0.017), GAT: - .306 (0.041) versus - .296 (0.048)). Statistical differences were found in comparing the iCare readings with GAT (P < 0,00) and with NCT (P < 0,00), with mean differences of 1.8 mmHg ± 2.6 and 2.0 mmHg ± 2.6 respectively. GAT and NCT measurements showed no statistical difference (P > 0.05). CONCLUSION This study shows that both central corneal thickness and stromal density are significant influential factors of reliable IOP readings. It is necessary to consider more corneal biomechanical properties, as well as exercise a high degree of caution in any new attempts towards adjusting an IOP-correction equation.
Collapse
Affiliation(s)
- Ahmed Lubbad
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany.
- , Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | | | - Melanie Haar
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
| | - Carsten Framme
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
| | - Anna Bajor
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
4
|
Ashano O, Oderinlo O, Ogunro A, Ashano E. A comparison of goldmann applanation tonometry and rebound tonometry measurements among patients attending a glaucoma clinic in Southwest Nigeria. Niger J Clin Pract 2022; 25:1542-1547. [DOI: 10.4103/njcp.njcp_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
5
|
Elfwwal MM, Elbasty MK, Khattab MF, ElShazly MI. Comparison between different tonometers following intrastromal corneal ring segments implantation. Eur J Ophthalmol 2021; 32:43-49. [PMID: 34472983 DOI: 10.1177/11206721211042546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare different intraocular pressure (IOP) readings in corneas with intrastromal corneal ring segments (ICRS) taken by three different tonometers; Goldmann applanation tonometry (GAT), air puff tonometer, and ocular response analyzer (ORA) corneal-compensated IOP (ORA-IOPcc) and determine the relation of these measurements to different corneal parameters taken by Pentacam. METHODS An observational cross-sectional analytic study included patients who underwent ICRS keraring implantation at 3 months. In each eye, the two rings were placed using the femtosecond laser assisted technique 5.5 or 6 mm from the center. IOP was measured using three different tonometers; GAT, air puff tonometer, and ocular response analyzer (ORA) corneal-compensated IOP (ORA-IOPcc). RESULTS Fifty eyes of 30 patients (20 males and 10 females) aged 27.56 ± 6.38 years were included. IOP measurements by GAT, air puff tonometer, and ORA-IOPcc were 13.28 ± 2.13 mmHg, 10.47 ± 2.55 mmHg, and 13.19 ± 2.78 mmHg, respectively. Comparisons between air puff and each of GAT and ORA-IOPcc were statistically highly significant (p-value <0.001). CONCLUSION IOP measurements taken by air puff tonometer were significantly lower than those taken by GAT and ORA-IOPcc. These differences were not constant across the pressure range but increased as the pressure values determined using GAT and ORA increased. ORA-IOPcc and GAT showed similar readings. No correlation was found between any of the IOP readings taken by the three tonometers and the central corneal thickness.
Collapse
|
6
|
Chen A, Virk A, Harris Z, Abazari A, Honkanen R, Arbab MH. Non-contact terahertz spectroscopic measurement of the intraocular pressure through corneal hydration mapping. BIOMEDICAL OPTICS EXPRESS 2021; 12:3438-3449. [PMID: 34221670 PMCID: PMC8221940 DOI: 10.1364/boe.423741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 05/03/2023]
Abstract
Elevated intraocular pressure (IOP) results in endothelial layer damage that can induce corneal hydration perturbations. We investigated the potential of terahertz spectroscopy in measuring the IOP levels through mapping corneal water content. We controlled the IOP levels in ex vivo rabbit and porcine eye samples while monitoring the change in corneal hydration using a terahertz time-domain spectroscopy (THz-TDS) scanner. Our results showed a statistically significant increase in the THz reflectivity between 0.4 and 0.6 THz corresponding to the increase in the IOP. Endothelial layer damage was confirmed using scanning electron microscopy (SEM) of the corneal biopsy samples. Our empirical results indicate that the THz-TDS can be used to track IOP levels through the changes in corneal hydration.
Collapse
Affiliation(s)
- Andrew Chen
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Arjun Virk
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Zachery Harris
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Azin Abazari
- Department of Ophthalmology, Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Robert Honkanen
- Department of Ophthalmology, Renaissance School of Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - M. Hassan Arbab
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794, USA
| |
Collapse
|
7
|
Campbell P, Edgar DF, Shah R. Inter-optometrist variability of IOP measurement for modern tonometers and their agreement with Goldmann Applanation Tonometry. Clin Exp Optom 2021; 104:602-610. [DOI: 10.1080/08164622.2021.1878831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Peter Campbell
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
- Department of Ophthalmology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - David F Edgar
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Rakhee Shah
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| |
Collapse
|
8
|
Kyei S, Gboglu CP, Kwarteng MA, Assiamah F. Comparative Assessment of The Goldmann Applanation and Noncontact Tonometers in Intraocular Pressure Measurements in a Sample of Glaucoma Patients in the Cape Coast Metropolis, Ghana. Niger Med J 2020; 61:323-327. [PMID: 33888929 PMCID: PMC8040943 DOI: 10.4103/nmj.nmj_177_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/16/2020] [Accepted: 10/11/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: The objective of the study was to explore the usage of the Goldmann applanation tonometry and noncontact tonometry interchangeably in the measurement of intraocular pressure (IOP) in glaucoma patients. Materials and Methods: The study involved 441 clinically diagnosed glaucoma patients receiving care at a referral facility. IOP measurements were obtained using both the Noncontact tonometer and Goldmann applanation tonometer The repeatability of the measures was analyzed by comparing the repeated measures of the devices using paired t-test and calculating the correlation coefficient. A Bland–Altman analysis was used to determine the limits of agreement between the two procedures. Results: There were 271 (61.5%) males and 170 (38.5%) females and their age ranged from 18 to 73 years (mean age = 49.37; standard deviation ± 14.81 years). The findings of the study showed significantly lower readings (P < 0.001) of the GAT (right eye = 17.40 ± 7.48 mmHg; left eye = 16.80 ± 7.49 mmHg) compared to the NCT (right eye = 20.15 ± 8.30 mmHg; left eye = 19.74 ± 8.31 mmHg). There was a strong positive correlation between the GAT and NCT findings in the right eye (r = 0.871, n = 441, P < 0.001) and in the left eye (r = 0.887, n = 441, P < 0.001). There was a wide limit of agreement between NCT and GAT measurements. Conclusion: There was statistically significant higher measures obtained with NCT than the GAT but did not exceed the allowable inter-device difference. There was a strong positive correlation between GAT and NCT measurements. However, it is strongly recommended that these devices are not used interchangeably in the monitoring of IOP in glaucoma due to the wide range of limits of agreement.
Collapse
Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.,Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe
| | - Cynthia Pakyennu Gboglu
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Agyemang Kwarteng
- Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.,Discipline of Optometry, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Frank Assiamah
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
9
|
Uzlu D, Akyol N, Türk A, Oruç Y. A comparison of three different tonometric methods in the measurement of intraocular pressure in the pediatric age group. Int Ophthalmol 2020; 40:1999-2005. [DOI: 10.1007/s10792-020-01375-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
|
10
|
Mendez-Hernandez C, Arribas-Pardo P, Sanchez Jean R, Garcia-Feljoo J. Influence of Axial Length on Intraocular Pressure Measurement With Three Tonometers in Childhood Glaucoma. J Pediatr Ophthalmol Strabismus 2020; 57:27-32. [PMID: 31972037 DOI: 10.3928/01913913-20191106-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/03/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the agreement between intraocular pressure (IOP) measurements obtained using the handheld version of the Goldmann applanation (Perkins; Clement-Clarke, Haag-Streit, Harlow, United Kingdom), rebound Icare-Pro (Icare, Tiolat Oy, Helsinki, Finland), and Tonopen XL (Reichert Inc., Depew, NY) tonometers in children with childhood glaucoma and to identify factors that may affect those measurements. METHODS Ninety-one eyes of 46 children with early-onset childhood glaucoma were included in this cross-sectional study in which IOP, ocular axial length, anterior chamber depth, lens thickness, vitreous length, and central corneal thickness measurements were obtained under general anesthesia. Agreement between tonometers was evaluated using intraclass correlation coefficients (ICCs) and the Bland-Altman method. The influence of ocular biometric parameters and central corneal thickness on IOP measurements was analyzed using multiple linear regression analysis. RESULTS The mean age of the children in the current study was 29.1 months (range: 13 to 31 months). The Icare-Pro and Tonopen XL overestimated IOP measurements compared to the Perkins tonometer (Icare-Pro-Perkins mean IOP difference: 2.2 ± 3.4 mm Hg, P < .0001, 95% confidence interval [CI]: 1.5 to 2.9 vs Tonopen XL-Perkins mean IOP difference: 6.7 ± 7.1 mm Hg, P < .0001, 95% CI: 5.2 to 8.2). The Icare-Pro showed greater agreement with the Perkins tonometer than the Tonopen XL (ICC: 0.789, 95% CI: 0.697 to 0.856, P < .0001 vs 0.453, 95% CI: 0.272 to 0.603, P < .0001). Ocular axial length affected IOP measurements the most, finding increased impact on Tonopen XL (slope: 0.086, 95% CI: 0.013 to 0.16, P = .022 vs 0.997, 95% CI: 0.369 to 1.625, P = .002 vs 1.571, 95% CI: 0.541 to 2.602, P < .0001 for Perkins, Icare-Pro, and Tonopen XL IOP measurements, respectively). CONCLUSIONS Ocular axial length affects IOP measured by the Perkins, Icare-Pro, and Tonopen XL devices in patients with childhood glaucoma. The Icare-Pro shows more agreement with the Perkins tonometer than the Tonopen XL; therefore, it seems to be a more suitable option for these patients. [J Pediatr Ophthalmol Strabismus. 2020;57(1):27-32.].
Collapse
|
11
|
Kutzscher AE, Kumar RS, Ramgopal B, Rackenchath MV, Sathi Devi, Nagaraj S, Moe CA, Fry DM, Stamper RL, Keenan JD. Reproducibility of 5 Methods of Ocular Tonometry. ACTA ACUST UNITED AC 2019; 2:429-434. [DOI: 10.1016/j.ogla.2019.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/15/2019] [Accepted: 07/29/2019] [Indexed: 11/25/2022]
|
12
|
Intraocular pressure according to different types of tonometry (non-contact and Goldmann applanation) in patients with different degrees of bilateral tearing. PLoS One 2019; 14:e0222652. [PMID: 31525237 PMCID: PMC6746371 DOI: 10.1371/journal.pone.0222652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 09/03/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate intraocular pressure (IOP) readings by non-contact tonometry (NCT) and Goldmann applanation tonometry (GAT) for patients with different degrees of bilateral tearing. Methods In this study, we reviewed the medical charts of patients complaining of different degrees of bilateral tearing. The tear meniscus height (TMH) and IOP with NCT and GAT were measured. In each patient, a comparison of IOP readings between the eye with lower TMH and the contralateral eye with higher TMH was evaluated. The TMH was graded as follows: grade 1 (low): TMH < 0.2 mm; grade 2 (moderate): 0.2 mm ≤ TMH < 0.6 mm; grade 3 (high): TMH ≥ 0.6 mm. Subsequently, a comparison of IOP readings among eyes with low, moderate, and high TMH was also performed. Results A total of 120 eyes of 60 patients were enrolled. When comparing the two eyes of a patient, the eye with higher TMH showed higher NCT readings and larger difference in IOP readings between the two tonometries than the eye with lower TMH (P < 0.001 and P < 0.001, respectively). When TMH was classified into grades according to the degree, the high TMH eyes showed higher NCT readings than did the low and moderate TMH eyes (P < 0.001 and P = 0.001, respectively). In addition, the high TMH eyes showed a larger difference in IOP readings between the two tonometries than did the low and moderate TMH eyes (P < 0.001 and P < 0.001, respectively). Conclusion Eyes with higher TMH showed higher NCT readings and a larger difference in IOP between the two tonometries (NCT and GAT) than those with lower TMH. In patients with tearing, the NCT value may be inaccurate, so it is necessary to measure the GAT.
Collapse
|
13
|
Pagoulatos DD, Kapsala ZG, Makri OE, Georgalas IG, Georgakopoulos CD. Comparison of intraocular pressure using Goldmann applanation tonometry versus non-contact tonometry in eyes with high-viscosity silicone oil. Eur J Ophthalmol 2019; 30:494-499. [PMID: 30832494 DOI: 10.1177/1120672119833556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND To compare intraocular pressure (IOP) measurements using Goldmann applanation tonometer (GAT) and air tonometer (non-contact tonometry [NT]) in vitrectomized eyes with high-viscosity silicone oil tamponade, as well as in normal eyes. PATIENTS AND METHODS In this prospective comparative study, 32 eyes with silicone oil tamponade of high viscosity (5700 CS) and 32 normal fellow eyes were included. IOP was measured by GAT and air tonometer 30 ± 12 days after vitrectomy, while measurements of central corneal thickness (CCT) were also obtained. RESULTS In eyes with silicone oil, IOP was 20.09 ± 4.91 mmHg and 16.75 ± 3.86 mmHg using contact tonometer and air tonometer, respectively (p < 0.0001). In normal eyes, IOP was 16.41 ± 2.15 mmHg and 16.31 ± 2.49 mmHg using the same tonometry techniques and this difference was not statistically significant (p = 0.598). In addition, no significant correlation was detected between IOP measurements using both techniques and age, gender, CCT, and type of lens. CONCLUSIONS It seems that GAT overestimates IOP in eyes with high-viscosity silicone oil compared with NT, while both IOP measurement techniques in normal eyes provide similar values. Further assessment of available IOP measurement methods could possibly establish the most accurate technique for IOP estimation in vitrectomized eyes with silicone oil tamponade.
Collapse
Affiliation(s)
| | - Zoi G Kapsala
- Department of Ophthalmology, School of Medicine, University of Crete, Heraklion, Greece
| | - Olga E Makri
- Department of Ophthalmology, School of Medicine, University of Patras, Rio, Greece
| | - Ilias G Georgalas
- 1st Ophthalmology Department, National and Kapodistrian University of Athens, Athens, Greece
| | | |
Collapse
|
14
|
Arribas-Pardo P, Mendez-Hernández C, Valls-Ferran I, Puertas-Bordallo D. Icare-Pro Rebound Tonometer Versus Hand-held Applanation Tonometer for Pediatric Screening. J Pediatr Ophthalmol Strabismus 2018; 55:382-386. [PMID: 30074606 DOI: 10.3928/01913913-20180621-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 04/18/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) measurements obtained using the new rebound tonometer Icare-Pro (Icare, Tiolat Oy, Helsinki, Finland) and the hand-held version of the Goldmann applanation tonometer (Perkins; Clement Clarke, Haag-Streit, Harlow, United Kingdom) in healthy children during clinical practice. METHODS In this prospective study, three IOP measurements were made using each tonometer in a single session, starting with the Icare-Pro. Participants were 173 non-anesthetized patients aged 1 to 16 years. Measurements were made in both eyes but only data for the right eye were entered in the analysis. Central corneal thickness, anterior chamber depth, and axial length were also measured in each patient. Data were compared by determining interclass correlation coefficients (ICCs) for each tonometer and representing the differences detected as Bland-Altman plots. RESULTS Good linear correlation was observed between IOP readings obtained using the Perkins and Icare-Pro tonometers (r = 0.87, P < .001), although the Icare-Pro readings were slightly higher (mean IOP difference: 0.26 ± 1.58 mm Hg, P = .037). The 95% limits of agreement between the two methods were 2.8 to -3.4 mm Hg. The ICC was 0.857 (95% confidence interval: 0.810 to 0.893), indicating good agreement. For both tonometers, a low but significant correlation was detected between IOP and central corneal thickness or age. However, no correlation of IOP was found with axial length or anterior chamber depth. CONCLUSIONS Pediatric IOP measurements determined using the new Icare-Pro rebound tonometer showed good correlation with those obtained using the hand-held Perkins applanation tonometer in a routine clinical examination with no need for general anesthesia. [J Pediatr Ophthalmol Strabismus. 2018;55(6):382-386.].
Collapse
|
15
|
Kim JW, Jung JW. Clinical Evaluation of a Rebound Tonometer in Patients Who Underwent Penetrating Keratoplasty. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.12.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Woo Kim
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
16
|
Özcura F, Yıldırım N, Tambova E, Şahin A. Evaluation of Goldmann applanation tonometry, rebound tonometry and dynamic contour tonometry in keratoconus. JOURNAL OF OPTOMETRY 2017; 10:117-122. [PMID: 27402573 PMCID: PMC5383454 DOI: 10.1016/j.optom.2016.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/28/2016] [Accepted: 04/13/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE To compare the intraocular pressure (IOP) measurements obtained with the rebound tonometry (RT), dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) in keratoconic corneas and to investigate the effects of central corneal thickness (CCT) and corneal radius of curvature (CR) on IOP measurements. METHODS Sixty-three eyes of 63 keratoconus patients were enrolled in this cross-sectional study. IOP was measured on each subject always in the same order, ICare RT-Pascal DCT-GAT, after a minimum interval of 10min between measurements. CCT and CR were measured using a rotating Scheimpflug camera before the IOP measurements in all subjects. One way repeated measures ANOVA and Pearson correlation coefficient analysis was used for the statistical assessment. RESULTS Mean IOP for all enrolled eyes was 11.72±2.59mmHg for GAT, 9.34±3.29mmHg for RT, and 15.42±3.31mmHg for DCT. There were statistically significant differences among the three tonometers; GAT and RT (P<0.001), GAT and DCT (P<0.001), and RT and DCT (P<0.001). GAT and RT were significantly positively correlated with CCT (r=0.288, P=0.025 and r=0.483, P<0.001, respectively). RT was also significantly positively correlated with CR (r=0.550, P<0.001). DCT was not significantly correlated with CCT (r=0.115, P=0.377) nor CR (r=-0.179, P=0.168). CONCLUSIONS DCT has overestimated but RT has underestimated IOP readings according to GAT measurements in keratoconic corneas. DCT may be the most appropriate tonometer to use in keratoconus for the measurements of IOP, because DCT do not appear to be dependent upon CCT and CR.
Collapse
Affiliation(s)
- Fatih Özcura
- Department of Ophthalmology, Dumlupinar University School of Medicine, Kutahya 43270, Turkey.
| | - Nilgün Yıldırım
- Department of Ophthalmology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| | - Emre Tambova
- Department of Ophthalmology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| | - Afsun Şahin
- Department of Ophthalmology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| |
Collapse
|
17
|
Feng CS, Jin KW, Yi K, Choi DG. Comparison of Intraocular Pressure Measurements Obtained by Rebound, Noncontact, and Goldmann Applanation Tonometry in Children. Am J Ophthalmol 2015. [PMID: 26210864 DOI: 10.1016/j.ajo.2015.07.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) among rebound, noncontact, and Goldmann applanation tonometry (GAT) and their relationships to central corneal thickness in children. DESIGN Diagnostic protocol comparison and evaluation. METHODS In right eyes of 419 children, mean IOP, rates of successful measurement with 3 tonometries, and intermethod agreement by Bland-Altman plot were assessed. The influences of central corneal thickness, and of average IOP of 3 tonometries on IOP differences between tonometries, were evaluated. RESULTS The mean age was 8.89 ± 3.41 years (3-15 years). There was significant difference in mean IOP of each tonometry; GAT showed the lowest values (P < .05). The IOP was successfully measured by noncontact tonometry in 89%, by rebound tonometry in 75%, and by GAT in 64% of children less than 10 years old, and in 100%, 98%, and 94% of children older than 10 years, respectively. The IOP of each tonometer positively correlated with central corneal thickness (P < .05). The mean differences and limits of agreement were 0.81 ± 6.19 mm Hg (noncontact minus rebound), 2.56 ± 4.62 mm Hg (rebound minus GAT), and 1.81 ± 4.76 mm Hg (noncontact minus GAT). Rebound and noncontact tonometry overestimated IOP relative to GAT for thicker central corneal thicknesses. Rebound tonometry overestimated IOP relative to GAT and noncontact tonometry at higher average IOP of 3 tonometries. CONCLUSIONS Rebound, noncontact, and Goldmann applanation tonometries can be considered appropriate methods for children, though noncontact tonometry is the most accessible. Given the risk of false-positive diagnosis of pediatric glaucoma, attention should be devoted to children with IOP within a suspicious range or thicker cornea.
Collapse
|
18
|
McKee EC, Ely AL, Duncan JE, Dosunmu EO, Freedman SF. A comparison of Icare PRO and Tono-Pen XL tonometers in anesthetized children. J AAPOS 2015; 19:332-7. [PMID: 26235790 DOI: 10.1016/j.jaapos.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/12/2015] [Accepted: 04/25/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tonometry in the anesthetized child, vital for evaluating known or suspected glaucoma, remains limited to tonometers capable of supine recording. The Icare PRO measures intraocular pressure (IOP) in the sitting or supine patient. The purpose of this study was to compare Icare PRO and Tono-Pen tonometry during examination under anesthesia in eyes of supine children with normal eyes and glaucoma and/or corneal pathology. METHODS In this prospective study of children undergoing examination under anesthesia, IOP was recorded in both eyes with Icare PRO and Tono-Pen immediately after mask anesthesia induction, with instrument order randomized. RESULTS A total of 100 eyes of 50 children (median age, 58 months) were included. IOP range was 6-50 mm Hg by Icare PRO and 6-53 mm Hg by Tono-Pen. Mean IOP measured by Tono-Pen (18.9 ± 7.5) was higher than that measured by Icare PRO (16.7 ± 7.1 mm Hg) by 2.2 mm Hg (P < 0.001). The presence of corneal edema was associated with IOP measurements higher by Tono-Pen than by Icare PRO (mean difference, 8.4 mm Hg). When eyes with corneal edema were excluded from analysis, there was no correlation between central corneal thickness and the difference in IOP between the two instruments. CONCLUSIONS IOP in eyes of supine children under anesthesia measured approximately 2 mm Hg higher by Tono-Pen than Icare PRO and this difference was greater in eyes with frank corneal edema. Icare PRO may become a valuable tool for tonometry in supine infants and children, but a confirmatory test should be considered in eyes with corneal edema.
Collapse
|
19
|
Nacaroglu SA, Un ES, Ersoz MG, Tasci Y. Intraocular pressure measurement over soft contact lens by rebound tonometer: a comparative study. Int J Ophthalmol 2015; 8:540-3. [PMID: 26086004 DOI: 10.3980/j.issn.2222-3959.2015.03.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 08/29/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the intraocular pressure (IOP) measurements by Icare rebound tonometer over a contact lens in comparison with Goldmann applanation tonometry (GAT). METHODS Fifty patients using contact lens were included in this study. One of the eyes of the patients was selected randomly and their IOP were measured by rebound tonometer with and without contact lens (RTCL, RT respectively) and by GAT, as well as their central corneal thickness (CCT) by optical pachymeter. The results of both methods were compared by correlation analysis, general linear method repeated measure and Bland-Altman analysis. RESULTS Mean IOP values measured by RTCL, RT and GAT were 15.68±3.7, 14.50±3.4 and 14.16±2.8 (P<0.001), respectively. Mean IOP by RTCL was significantly higher than the measurements implemented by RT and GAT (P<0.001), while there was no difference between the measurements by GAT and RT (P=0.629). There was a good level of positive correlation between GAT and RTCL as well as RT (r=0.786 P<0.001, r=0.833 P<0.001, respectively). We have observed that CCT increase did not show any correlation with the differences of the measurements between RTCL and RT (P=0.329), RTCL and GAT (P=0.07) as well as RT and GAT (P=0.189) in linear regression model. CONCLUSION The average of the measurements over contact lens by rebound tonometer was found to be higher than what was measured by GAT. Although this difference is statistically significant, it may be clinically negligible in the normal population.
Collapse
Affiliation(s)
- Senay Asik Nacaroglu
- Department of Ophthalmology, Tepecik Traning and Research Hospital, Izmir 35240, Turkey
| | - Emine Seker Un
- Department of Ophthalmology, Tepecik Traning and Research Hospital, Izmir 35240, Turkey
| | - Mehmet Giray Ersoz
- Department of Ophthalmology, Tepecik Traning and Research Hospital, Izmir 35240, Turkey
| | - Yelda Tasci
- Department of Ophthalmology, Akdagmadeni State Hospital, Yozgat 66300, Turkey
| |
Collapse
|
20
|
Tam�elik N, Atalay E, Cicik E, �zk�k A. Comparability of Icare Pro Rebound Tonometer with Goldmann Applanation and Noncontact Tonometer in a Wide Range of Intraocular Pressure and Central Corneal Thickness. Ophthalmic Res 2015; 54:18-25. [DOI: 10.1159/000381781] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/17/2015] [Indexed: 11/19/2022]
|
21
|
Özcura F, Yildirim N, Şahin A, Çolak E. Comparison of Goldmann applanation tonometry, rebound tonometry and dynamic contour tonometry in normal and glaucomatous eyes. Int J Ophthalmol 2015; 8:299-304. [PMID: 25938044 DOI: 10.3980/j.issn.2222-3959.2015.02.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/11/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the intraocular pressure (IOP) measurements obtained with the rebound tonometry (RT), dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) in normal and glaucomatous eyes and investigate the effects of central corneal thickness (CCT) and corneal curvature (CC) on IOP measurements. METHODS One hundred and twenty-four eyes of 124 subjects were enrolled in this cross-sectional study. Fifty-six of participants were healthy individuals and 68 of them were glaucomatous patients. IOP was measured on each subject always in the same order, ICare RT-Pascal DCT-GAT, after a minimum interval of 10min between measurements. CCT and CC were measured using a rotating Scheimpflug camera before the IOP measurements in all subjects. One way repeated measures ANOVA, Pearson correlation coefficient and regression analysis, and Bland-Altman analysis was used for the statistical assessment. RESULTS Mean IOP for all enrolled eyes was 16.00±3.80 mm Hg for GAT, 16.99±4.91 mm Hg for RT, and 20.40±4.44 mm Hg for DCT. Mean differences between GAT and RT was -1.75±3.41 mm Hg in normal (P<0.001) and -0.37±3.00 mm Hg in glaucomatous eyes (P=0.563). Mean differences between GAT and DCT was -4.06±3.42 mm Hg in normal (P<0.001) and -4.67±3.12 mm Hg in glaucomatous eyes (P<0.001). GAT and RT were significantly positive correlated with CCT in normal (r=0.317, P=0.017 and r=0.576, P<0.001, respectively) and glaucomatous eyes (r=0.290, P=0.016 and r=0.351, P=0.003, respectively). DCT was also significantly positive correlated with CCT in normal eyes (r=0.424, P=0.001) but not in glaucomatous eyes (r=0.170, P=0.165). All tonometers were unaffected by CC. CONCLUSION IOP measurements by RT and DCT were significantly higher than GAT. DCT has highest IOP measurements among these tonometers. RT was most influenced tonometer from CCT although all tonometers were significantly positive correlated with CCT except DCT in glaucomatous eyes. CC did not influence IOP measurements.
Collapse
Affiliation(s)
- Fatih Özcura
- Department of Ophthalmology, Dumlupinar University School of Medicine, Kutahya 43270, Turkey
| | - Nilgün Yildirim
- Department of Ophthalmology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| | - Afsun Şahin
- Department of Ophthalmology, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| | - Ertuğrul Çolak
- Department of Biostatistics and Medical Informatics, Eskisehir Osmangazi University School of Medicine, Eskisehir 26480, Turkey
| |
Collapse
|
22
|
Park SU, Han SB, Kim MS, Lee SJ. Correlation between Intraocular Pressure and Bottle Heights during Vitrectomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.5.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Uk Park
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sang Beom Han
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Moo Sang Kim
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Seung Jun Lee
- Department of Ophthalmology, Kangwon National University School of Medicine, Chuncheon, Korea
| |
Collapse
|
23
|
Rimayanti U, Kiuchi Y, Uemura S, Takenaka J, Mochizuki H, Kaneko M. Ocular surface displacement with and without contact lenses during non-contact tonometry. PLoS One 2014; 9:e96066. [PMID: 24781212 PMCID: PMC4004546 DOI: 10.1371/journal.pone.0096066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 04/03/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the displacement of the central ocular surface during non-contact tonometry with and without soft contact lenses and determine the factors associated with the displacement of the central ocular surface and intraocular pressure (IOP) reading changes caused by wearing soft contact lenses (CLs). METHODS One eye each in 21 subjects was studied. The cornea was photographed using a high-speed camera at 5,000 frames/sec during non-contact tonometry without contact lenses (NCL), with -5.0 diopters (D), -0.5 D and +5.0 D CL. The displacement of the ocular surface and the factors affecting displacement at the IOP reading and maximum displacement time were investigated. RESULTS The IOP readings while wearing +5 D CL were significantly higher than those obtained while wearing -5 D CL. The ocular surface displacement between +5 D CL and other groups were significantly different. A significant positive correlation was found between the ocular surface displacement of subjects at the IOP reading time and the IOP obtained with the non-contact tonometer. A significant negative correlation was found between the ocular surface curvature and the IOP obtained using the non-contact tonometer. The radius of curvature of the ocular surface affected the displacement during the IOP reading and maximum displacement time. CONCLUSIONS Our results indicate that soft contact lens use changes the ocular surface behavior and IOP readings during non-contact tonometry. The radius of curvature of the eye affects the ocular surface displacement and IOP readings in this situation.
Collapse
Affiliation(s)
- Ulfah Rimayanti
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shohei Uemura
- Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Joji Takenaka
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Mochizuki
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Kaneko
- Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka, Japan
| |
Collapse
|
24
|
Salvetat ML, Zeppieri M, Tosoni C, Brusini P. Repeatability and accuracy of applanation resonance tonometry in healthy subjects and patients with glaucoma. Acta Ophthalmol 2014; 92:e66-73. [PMID: 23837834 DOI: 10.1111/aos.12209] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate the repeatability and accuracy of the applanation resonance tonometer (ART) used in the automatic servo-controlled version, and to evaluate the influence of central corneal thickness (CCT) on the ART intraocular pressure (IOP) measurements. METHODS This prospective, randomized, single-centre study included one eye of 153 subjects (35 healthy volunteers and 118 patients with glaucoma). All participants underwent ultrasonic CCT measurement, followed by IOP evaluation with Goldmann applanation tonometer (GAT) and ART in random order. A single operator measured the IOP with each tonometer three times. Intra-examiner variability was evaluated using the coefficient of variation (CoV), intraclass correlation coefficient (ICC) and test-retest differences. Intermethod agreement was assessed using the Bland-Altman method. Linear regression analysis was used to evaluate the relationship between IOP measurements and CCT. RESULTS The mean IOP was 17.7 ± 4.4 mmHg with GAT and 20.6 ± 5.3 mmHg with ART (p < 0.001). CoV and ICC were, respectively, 5 ± 3% and 0.99 for GAT, and 8 ± 4% and 0.96 for ART (intermethods differences, p = 0.001). The ART test-retest differences significantly increased with increasing mean IOP (p = 0.003). The mean IOP difference (ART minus GAT) was 3.0 ± 4.0 mmHg, which increased with increasing mean IOP (p < 0.001). Both GAT IOP and ART IOP readings were significantly directly related to the CCT values (p = 0.03 and p = 0.004, respectively; intermethods difference, p = 0.32). CONCLUSIONS The ART intra-examiner repeatability was excellent, although significantly lower than that of GAT, and decreased at higher IOP levels. ART significantly overestimated GAT IOP measurements, especially at higher IOP range. Both GAT and ART appeared similarly influenced by CCT value.
Collapse
Affiliation(s)
- Maria L Salvetat
- Department of Ophthalmology, Azienda Ospedaliero-Universitaria 'Santa Maria della Misericordia', Udine, Italy
| | | | | | | |
Collapse
|
25
|
Saenz-Frances F, Jañez L, Borrego-Sanz L, Martinez-de-la-Casa JM, Morales-Fernandez L, Santos-Bueso E, Garcia-Sanchez J, Garcia-Feijoo J. Characterization of the thickness of different corneal zones in glaucoma: effect on dynamic contour, Goldmann and rebound tonometries. Acta Ophthalmol 2013; 91:e620-7. [PMID: 23764044 DOI: 10.1111/aos.12154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To characterize five models of corneal thickness circular zoning in a sample of healthy controls and a sample of patients with primary open-angle glaucoma (POAG) and to determine their effect on Goldmann (GAT), dynamic contour (DCT) and rebound tonometers (RT). METHODS The study participants were 122 controls and 129 cases. Five corneal thickness zoning models (A, B, C, D and E) were constructed. The partitioning pattern consisted of a circle centred at the corneal apex and several concentric rings, until the limbus; the contours of each ring followed the geometry of the corneal contour of each participant. In Model A, the central circle was 1 mm in diameter and five concentric rings were established. Mean was obtained for each zone for both samples and compared between them using a t-test. The effect on the tonometers of central cornel thickness (CCT) and mean thickness of the zones generated was determined through several linear regression models (one per tonometer and per sample). RESULTS According to a t-test, cases and controls differ in zones I [mean difference (MD): 17.93 μm], V (MD: 25.52 μm) and VI (MD: 31.78 μm) of model A (higher values in the cases sample). RT was affected by CCT (controls: B = 0.089; cases: B = 0.081). DCT was affected by zone IV of model A (controls: B = -0.029; cases: B = -0.012). GAT was affected by CCT (controls: B = 0.043; cases: B = 0.025) and zone III of model A (controls: B = -0.045; cases: B = -0.033). CONCLUSION Our results highlight the importance of the thickness of other regions of the cornea different from its main centre in discriminating between healthy controls and patients with POAG and in IOP measurements made using DCT, GAT and RT.
Collapse
Affiliation(s)
- Federico Saenz-Frances
- Department of Ophthalmology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, SpainInstiuto de Tecnología del Conocimiento, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Does rebound tonometry probe misalignment modify intraocular pressure measurements in human eyes? J Ophthalmol 2013; 2013:791084. [PMID: 24073330 PMCID: PMC3773447 DOI: 10.1155/2013/791084] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/01/2013] [Indexed: 11/17/2022] Open
Abstract
Purpose. To examine the influence of positional misalignments on intraocular pressure (IOP) measurement with a rebound tonometer. Methods. Using the iCare rebound tonometer, IOP readings were taken from the right eye of 36 healthy subjects at the central corneal apex (CC) and compared to IOP measures using the Goldmann applanation tonometer (GAT). Using a bespoke rig, iCare IOP readings were also taken 2 mm laterally from CC, both nasally and temporally, along with angular deviations of 5 and 10 degrees, both nasally and temporally to the visual axis. Results. Mean IOP ± SD, as measured by GAT, was 14.7 ± 2.5 mmHg versus iCare tonometer readings of 17.4 ± 3.6 mmHg at CC, representing an iCare IOP overestimation of 2.7 ± 2.8 mmHg (P < 0.001), which increased at higher average IOPs. IOP at CC using the iCare tonometer was not significantly different to values at lateral displacements. IOP was marginally underestimated with angular deviation of the probe but only reaching significance at 10 degrees nasally. Conclusions. As shown previously, the iCare tonometer overestimates IOP compared to GAT. However, IOP measurement in normal, healthy subjects using the iCare rebound tonometer appears insensitive to misalignments. An IOP underestimation of <1 mmHg with the probe deviated 10 degrees nasally reached statistical but not clinical significance levels.
Collapse
|
27
|
Kim KN, Jeoung JW, Park KH, Yang MK, Kim DM. Comparison of the new rebound tonometer with Goldmann applanation tonometer in a clinical setting. Acta Ophthalmol 2013; 91:e392-6. [PMID: 23521889 DOI: 10.1111/aos.12109] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the clinical usefulness of a new rebound tonometer, Icare(®) PRO (Icare PRO), by comparison with Goldmann applanation tonometry (GAT) in a study on patients with glaucoma. METHODS One hundred and seventy-two eyes of 86 subjects were enrolled in this study. All of the subjects were examined with an autorefractometer, Icare PRO, slit-lamp biomicroscope, GAT, ultrasound A-scan and pachymeter. Three intraocular pressure (IOP) measurements were obtained by Icare PRO and GAT. The intraobserver reliabilities were established by calculating the intraclass correlation coefficients. The Bland-Altman plot was used to compare the Icare PRO and GAT. RESULTS There was a good correlation between the IOP measurement by GAT and that by Icare PRO (r = 0.6995, p < 0.001). The intraclass correlation coefficients of Icare PRO and GAT were 0.778 and 0.955, respectively. The IOP differences between Icare PRO and GAT (mean: 1.92 mmHg; SD: 3.29 mmHg; 95% limit of agreement: -4.52 to 8.37 mmHg) did not vary over the wide range of central corneal thickness (p = 0.498), age (p = 0.248), axial length (p = 0.277) or spherical equivalent (p = 0.075). CONCLUSIONS Although IOP with Icare PRO was higher than that with GAT, especially at lower GAT IOP value, Icare PRO was found to be a reliable method and showed a good correlation with GAT. The IOP difference between Icare PRO and GAT was not affected by the central corneal thickness, age, axial length or spherical equivalent. Icare PRO can be expected not only to be a good screening tool but also to be a good substitute for GAT.
Collapse
Affiliation(s)
- Kyoung Nam Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | | | | | | | | |
Collapse
|
28
|
Lambert SR, Melia M, Buffenn AN, Chiang MF, Simpson JL, Yang MB. Rebound Tonometry in Children. Ophthalmology 2013; 120:e21-7. [DOI: 10.1016/j.ophtha.2012.09.058] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/13/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022] Open
|
29
|
Anton A, Neuburger M, Böhringer D, Jordan JF. Comparative measurement of intraocular pressure by Icare tonometry and Airpuff tonometry in healthy subjects and patients wearing therapeutic soft contact lenses. Graefes Arch Clin Exp Ophthalmol 2013; 251:1791-5. [PMID: 23532453 DOI: 10.1007/s00417-013-2329-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 03/03/2013] [Accepted: 03/13/2013] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The aim of the present study was to compare the measurement of intraocular pressure (IOP) through a therapeutic soft contact lens with the "native" measurement. We additionally investigate whether a rebound tonometer (RT) or non-contact tonometer (NCT) is more suitable to measure IOP through a bandage contact lens. METHODS The IOP was determined using each of the two methods, three times successively with (lens measurement) and without (native measurement) a soft contact lens. The Icare tonometer (Icare® TA01i, Icare Finland Oy, 23 subjects) and the Airpuff tonometer (Nidek NT 53OP, Nidek CO., LTD, Hiroishi Gamagori, Aichi, Japan, 16 subjects) were used. We compared the mean values (validity parameter) and standard deviation (precision parameter) of the three individual measurements in each case using the paired t-test. In addition, we conducted a power analysis to estimate the maximum error in the measurement caused by the contact lens (power level set to 0.8). RESULTS With the Airpuff tonometer we detected no statistically significant between the lens and the native measurement (15.6 ± 2.6 vs. 15.3 ± 2.6 mmHg; p = 0.42). The power analysis revealed that the maximum error caused by the contact lens was 1.2 mmHg. The Icare tonometry, however, trended toward higher values in the contact lens measurements (17.5 ± 4.3 vs. 16.4 ± 3.5 mmHg in the native measurements; p = 0.05). Interestingly, this difference exhibited a statistically significant correlation with the corneal thickness (0.03 mmHg per μm corneal thickness; p = 0.04). CONCLUSION The use of NCT and RT for IOP measurement over a soft contact lens is feasible. The accuracy appears to be sufficient for the most common clinical applications.
Collapse
Affiliation(s)
- Alexandra Anton
- University Eye Hospital Freiburg, Killianstraße 5, 79106, Freiburg, Germany.
| | | | | | | |
Collapse
|
30
|
Farhood QK. Comparative evaluation of intraocular pressure with an air-puff tonometer versus a Goldmann applanation tonometer. Clin Ophthalmol 2012; 7:23-7. [PMID: 23293511 PMCID: PMC3534293 DOI: 10.2147/opth.s38418] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Tonometry, or measurement of intraocular pressure (IOP), is one of the most important examination procedures in ophthalmic clinics, and IOP is an important parameter in the diagnosis of glaucoma. Because there are numerous types of tonometer available, it is important to evaluate the differences in readings between different tonometers. Goldmann applanation tonometers (GATs) and noncontact air-puff tonometers (APTs) are largely available in ophthalmic clinics. The purpose of this study was to evaluate the role of AP tonometer by comparing the measurements of IOP made using this device with those made using a GAT. PATIENTS AND METHODS This study involved 196 eyes from 98 study participants, all of whom were patients attending an ophthalmic outpatient clinic. Each patient's IOP was measured using both Goldmann applanation tonometry and AP tonometry, and the difference in readings between the two methods was calculated. RESULTS The mean IOP as measured by GAT was 13.06 ± 4.774 mmHg, while that as measured by AP tonometer was 15.91 ± 6.955 mmHg. The mean difference between the two methods of measurement was 2.72 ± 2.34 mmHg. The readings obtained by AP tonometer were higher than those obtained by GAT in 74% of patients, and this difference was most obvious when the GAT measurement of IOP exceeded 24 mmHg. No statistically significant variation in IOP was noted between the devices when the patients' age, sex, and laterality (right and left eyes) were considered. CONCLUSION There is a significant difference in the measurement of IOP between GATs and AP tonometers. Goldmann applanation tonometry remains the most suitable and reliable method for measuring IOP. Because measurements of IOP by AP tonometer are usually higher than those obtained by GAT regardless of the patient's age, sex, or laterality of eyes, AP tonometry is a suitable method for community or mass screenings of IOP.
Collapse
Affiliation(s)
- Qasim K Farhood
- Department of Ophthalmology, College of Medicine, University of Babylon, Babylon, Iraq
| |
Collapse
|
31
|
Ogbuehi KC, Mucke S, Osuagwu UL. Influence of central corneal thickness on measured intraocular pressure differentials: Nidek RKT-7700, Topcon CT-80 NCTs and Goldmann Tonometer. Ophthalmic Physiol Opt 2012; 32:547-55. [PMID: 23009324 DOI: 10.1111/j.1475-1313.2012.00945.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/31/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE We sought to compare the intraocular pressure (IOP) measured by RKT-7700 and CT-80 noncontact tonometers (NCTs) with that measured by Goldmann applanation tonometry (GAT). We also examined the influence of central corneal thickness (CCT) on the agreement between both NCTs and GAT in a sub-population of healthy, young normals. METHODS Triplicate IOP and CCT measurements were obtained twice from one randomized eye of 49 subjects (28 males and 21 females) aged 22.2 ± 1.3 (mean ± S.D.) years. Goldmann tonometry was performed subsequent to assessment with the RKT-7700 and CT-80, to negate the 'ocular massage effect', followed by ultrasound pachymetry. The results from each method were compared and assessed for repeatability and between-observer reproducibility. Analysis was performed to determine the correlation between the differences in IOP measurements and corneal thicknesses. RESULTS The mean differences (±S.D.) in sessions 1 and 2 respectively between RKT-7700 and GAT (2.6 ± 2.0 and 2.7 ± 1.4 mmHg), between CT-80 and GAT (2.8 ± 2.0 and 3.2 ± 1.3 mmHg) were statistically significant (p < 0.0001). The repeatability coefficients in sessions 1 and 2 respectively were; ±1.2 and ±1.0 mmHg (GAT), ±1.3 and ±1.6 mmHg (CT-80), ±2.3 and ±1.7 mmHg (RKT-7700) and inter-observer reproducibility was; ±1.9 (RKT-7700), ±2.3 (GAT) and ±2.6 mmHg (CT-80). Between the corneal thickness and the differences in GAT-measured and NCT-measured IOPs, there was a significant negative correlation and a trend for a larger difference in thicker corneas. CONCLUSION Neither the RKT-7700 nor the CT-80 can be used interchangeably with the Goldmann tonometer, although all three tonometers give repeatable measurements of IOP, in this sub-population. IOP differences between GAT and the NCTs significantly correlated with CCT, with the possibility of even greater differences in thicker corneas.
Collapse
Affiliation(s)
- Kelechi C Ogbuehi
- Corneal Research Chair, Department of Optometry and Vision Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
32
|
Lee CM, Yu YC. Intraocular Pressure Measurement with the Noncontact Tonometer and Rebound Tonometer through Plano Soft Contact Lenses. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.5.662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Chang Mok Lee
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Young Cheol Yu
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| |
Collapse
|
33
|
Firat PG, Cankaya C, Doganay S, Cavdar M, Duman S, Ozsoy E, Koc B. The influence of soft contact lenses on the intraocular pressure measurement. Eye (Lond) 2011; 26:278-82. [PMID: 22079968 DOI: 10.1038/eye.2011.271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the influence of silicone hydrogel contact lenses on the intraocular pressure (IOP) measurement using Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), and Pascal dynamic contour tonometry (DCT). METHODS We included in the study 40 eyes of 40 patients who did not have any ocular or systemic diseases or contraindications to contact lens use. We measured and recorded the IOP values of each patient using NCT without and with contact lenses (groups 1 and 2, respectively), using DCT without and with contact lenses (groups 3 and 4, respectively), and using GAT without contact lenses (group 5). RESULTS The mean IOP value of group 1 was 14.55 ± 2.95 mm Hg and 13.92 ± 2.58 mm Hg in group 2. We detected no statistically significant difference between group 1 and group 2 (P=0.053). The mean IOP values for group 3 and group 4 were 16.26 ± 2.33 mm Hg and 15.19 ± 2.40 mm Hg, respectively. We detected a statistically significant difference between groups 3 and 4 (P=0.005). Group 5's mean IOP value was 12.97 ± 2.65 mm Hg. IOP values measured with DCT were statistically significantly higher compared with IOP values measured with NCT and GAT (P<0.0001 and P<0.0001, respectively). Additionally, IOP values measured with NCT were statistically significantly higher compared with IOP values measured with GAT (P<0.0001). CONCLUSION According to the results of our study, silicone hydrogel soft contact lens use does not significantly affect IOP values measured with NCT, but it affects IOP values measured with DCT.
Collapse
Affiliation(s)
- P G Firat
- Department of Ophthalmology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey.
| | | | | | | | | | | | | |
Collapse
|