Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes

Mollan, Susan P; Wolffsohn, James S.; Nessim, Maged; Laiquzzaman, Mohammad; Sivakumar, Subramaniam; Hartley, Stephanie; Shah, Sunil

doi:10.1136/bjo.2007.136473

Cited by 70 publications

(48 citation statements)

References 28 publications

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“…33,37,38 Furthermore, IOPcc may be one of the most appropriate measures of IOP before and after keratorefractive procedures and in eyes with keratoconus or corneal oedema. 14,[33][34][35][36]39 In light of these and other findings, the ORA is an appealing tool for the measurement of IOP and ocular biomechanical characteristics.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Ehrlich

Haseltine

Shimmyo

et al. 2010

Eye

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Purpose To compare agreement of intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and Goldmann correlated intraocular pressure generated (IOPg) by the Reichert ocular response analyser (ORA). Methods Consecutive patients presenting for glaucoma evaluation underwent ORA assessment followed by examination including GAT. For each ORA assessment, measurements were taken until a waveform score (WS) of 6.5 was obtained or until five measurements were obtained per eye. The relationship between GAT and IOPg and the influence of the WS upon this relationship was evaluated. A Bland-Altman plot and linear regression were used to determine agreement between GAT and IOPg. Results A total of 518 eyes of 260 patients were included in the final analysis. Increasing WS was found to predict a smaller difference between GAT and IOPg (b ¼ À0.2, Pp0.001). Selecting the highest WS among ORA assessments of each eye, WS continued to predict concordance between GAT and IOPg (b ¼ À0.2, P ¼ 0.006). The mean IOP difference between methods was 0.1 mm Hg (±0.3), which was found to be statistically insignificant (P ¼ 0.391). This relationship between GAT and IOPg was successfully validated using a second distinct data set of 100 eyes. GAT and IOPg measurements varied by 2 mm Hg or less in 53.9% of eyes and 5 mm Hg or less in 92.3% of eyes. Conclusion In clinical practice IOPg is strongly related to GAT. Although higher WS is indicative of greater IOPg/GAT concordance, its influence is minimal. This study does not support the use of a specific WS cutoff to determine quality of an IOPg measurement.

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Section: Discussionmentioning

confidence: 99%

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Ehrlich

Haseltine

Shimmyo

et al. 2010

Eye

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“…In 36 cases (18.2%), the difference between the mean IOPen and GAT IOPs was 1 mm Hg or less, and in 61 eyes (30.8%) it was 2 mm Hg or less; in 99 eyes (50%), it was 3 mm Hg or less. However, if the GAT IOP exceeded 20 mm Hg (seven cases), the median difference between the GAT and mean IOPen IOPs was 13 The mean scores of the IOPen quality were 1.21 ± 0.93, 1.10 ± 0.90 and 1.11 ± 0.89 for the first, second, and third IOPen measurements, respectively. No differences in quality were found between the three IOPen measurements (P ¼ 0.21).…”

Section: Resultsmentioning

confidence: 99%

“…10 Other tonometers, such as the TonoPen (Mentor, Norwell, MA, USA) also have a relationship with the CH and CRF. 13 Mollan et al suggested that corneal parameters, such as the CH and CRT may be more important than the CCT in causing inaccuracies in different tonometers. 13 In Table 2 the IOP comparison among tonometers according to gender and age is shown.…”

Section: Gendermentioning

confidence: 99%

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Comparation of the new rebound tonometer IOPen and the Goldmann tonometer, and their relationship to corneal properties

Moreno-Montañés

Gosende

Caire

et al. 2010

Eye

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Purpose To compare the intraocular pressures (IOPs) obtained with the IOPen rebound tonometer, Goldmann applanation tonometer (GAT) and the ocular response analyzer (ORA) and investigate the effects of corneal biomechanical properties on IOPen measurements. Methods A total of 198 normal eyes were included in this cross-sectional and randomized study. Three measurements were taken using IOPen. Agreement between tonometers was calculated using the Bland and Altman limits of agreement (LoA) analysis. Results The median IOPen IOP was 3 mm Hg below the GAT (Po0.001), 3 mm Hg below the ORA IOP similar to Goldmann (IOPg), and 3 mm Hg below the ORA IOP corrected using corneal parameters (IOPcc)(Po0.01). The LoA width between the IOPen and GAT IOPs varied between 13.92 (mean IOPen IOP) and 15.99 mm Hg (third IOPen measurement). The central corneal thickness (CCT) was unrelated to IOPen measurements (P40.05). Corneal hysteresis (CH) and corneal rigidity factor (CRF) were correlated with IOPen and GAT. Conclusions IOPen underestimated the IOP compared with GAT and ORA. The effect of measurement quality or measurement order on IOPen was low. CCT did not affect the IOPen, but the CH and CRF did. The LoA width between the IOPen and GAT IOPs was higher than between the ORA IOPg or ORA IOPcc and GAT IOPs.

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“…Obtaining an accurate IOP measurement is a greater challenge in keratoconic eyes. [2][3][4] Axial stromal thinning, progressive conical distortion with irregular astigmatism and apical protrusion make accurate measurement of IOP problematic. 5,6 Goldmann applanation tonometry (GAT) is still the gold standard for IOP measurement in the clinical management of glaucoma, although measurement errors due to central corneal thickness (CCT), axial length, and corneal curvature are known.…”

Section: Introductionmentioning

confidence: 99%

Which tonometry in eyes with keratoconus?

Altınkaynak

Kocasaraç

Dündar³

et al. 2015

Eye

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Aims To compare intraocular pressure (IOP) measurements obtained with Goldmann applanation tonometery (GAT), dynamic contour tonometry (DCT), tonopen (TP), and ocular response analyzer (ORA), and to determine the influence of Amsler grade and central corneal thickness (CCT) on the IOP readings in eyes with keratoconus that are classified into four groups according to the Amsler − Krumeich classification. Methods All eyes with keratoconus were separated into four groups using Amsler − Krumeich classification for keratoconus. IOP was measured in 202 eyes of 202 patients with keratoconus using GAT, DCT, TP, and ORA. Results The IOP differences revealed no significant difference among the Amsler degree in the DCT and corneal-compensated IOP (IOPcc) measurements (P40.05 for all).

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Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes

Cited by 70 publications

References 28 publications

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Comparation of the new rebound tonometer IOPen and the Goldmann tonometer, and their relationship to corneal properties

Which tonometry in eyes with keratoconus?

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