Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Realini, Tony; McMillan, Brian; Gross, Ronald L.; DeVience, Eva; Balasubramani, Goundappa K.

doi:10.1097/ijg.0000000000001892

Cited by 6 publications

(3 citation statements)

References 29 publications

(38 reference statements)

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“…We did find a difference in the agreement in IOP measurements between glaucoma patients and a glaucoma nurse clinician both using iCare HOME versus the agreement of glaucoma patients using iCare HOME compared with GAT. The former showed better agreement which is in keeping with Realini et al’s14 report of better intraoperator reproducibility of ICare model ic100 measurements compared with Goldmann measurements. They attribute this to Goldmann tonometry having many sources of error that vary over time making it unpredictable as opposed to the iCare rebound tonometer.…”

Section: Discussionsupporting

confidence: 90%

Accuracy and Reliability of Self-measured Intraocular Pressure in Glaucoma Patients Using the iCare HOME Tonometer

Ogle

Hoo

Chua

et al. 2021

Journal of Glaucoma

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The iCare HOME tonometer is a useful tool which can be used by patients for fairly accurate and reliable self-measurement of intraocular pressure (IOP).Purpose: The aim was to compare the accuracy of IOP measurements of trained glaucoma patients using the iCare HOME tonometer before and after a week of self-monitoring at home and study the repeatability of patient measurements done at home. Materials and Methods:A total of 40 glaucoma patients had IOPs measured using the Goldmann applanation tonometer and the iCare HOME. Patients were trained to use the iCare HOME and measured their IOP twice daily over a loan period of 7 days. Bland-Altman analysis was used to assess agreement between Goldmann applanation tonometer and iCare HOME readings. Intraclass correlation coefficient compared inter-rater reliability of iCare HOME measurements, and test-retest variability for the patient's readings over the 7-day period were analyzed. A 5-point Likert scale questionnaire was used to assess the patient's experience with the device.Results: Up to 32 patients (80%) were able to obtain IOP readings within 3 mm Hg of the glaucoma nurse clinician's readings at the preloan visit, and up to 36 patients (90%) at the postloan visit. Good inter-rater reliability was observed between iCare HOME measurements by the glaucoma nurse clinician and patients. At the postloan visit, inter-rater reliability was good for right eye readings and excellent for left eye readings. No distinct trend in test-retest variability was identified over the 7-day period. 65% of patients agreed the device was easy to use and 89% would recommend the device to other glaucoma patients. Conclusion:Patients trained to use the iCare HOME device can do so with fair accuracy compared with trainers with accuracy improving within 1 week of usage.

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Section: Discussionsupporting

confidence: 90%

Accuracy and Reliability of Self-measured Intraocular Pressure in Glaucoma Patients Using the iCare HOME Tonometer

Ogle

Hoo

Chua

et al. 2021

Journal of Glaucoma

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“…The VA values were converted to a logarithm of the minimum angle of resolution (logMAR). IOP was measured using an iCare tonometer (ic100, Finland Oy, Vantaa, Finland) [ 19 ]. The median values of three consecutive measurements were considered [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics

Kumar,

Bezzabotnov,

Rustamova

et al. 2023

Vision

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A surgical technique was developed to enhance aqueous humor (AH) flow through the non-trabecular outflow pathway by rerouting it from the anterior chamber (AC) to the suprachoroidal space (SCS) without detaching the ciliary body from the scleral spur. Medium- and long-term surgical outcomes were retrospectively analyzed in a case series of 58 glaucoma patients. At 6, 12, and 24 months, the mean IOP decreased from 27.8 ± 8.3 to 14.9 ± 5.0 mmHg, median 15.0 (25th percentile (p25)13.0; 75th percentile (p75) 18.0) and 15.2 ± 3.3 mmHg, and hypotensive medication use reduced from a median (p25; p75) of 3 (2; 3) to 0 (0; 2), 0 (0; 2), and 0 (0; 1.5), respectively. Intra- and postoperative complications were few and manageable. Following surgery, no bleb formation occurred in any of the cases (as confirmed by optical coherence tomography). Conjunctival lymphatic vessels (CLVs) developed in 50% of eyes (29/58). Clinically, they developed directly from sclera and had no connection to the surgical site. Analysis further showed that the development of CLVs and their longer visibility period had poor prognostic value for IOP control. If the fluid flow from the SCS to CLVs was resistance-free, no CLV development was evident. However, if any resistance existed in the flow, the fluid accumulated in lymphatics, resulting in their engorgement. The proposed technique was safe and effective in decreasing IOP in glaucoma patients by enhancing AH flow from the SCS to CLVs via connecting intrascleral microchannels.

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“…The VA values were converted to logMAR for analysis purposes. IOP was measured by an iCare tonometer (ic100, Icare Finland Oy, Vantaa, Finland) [ 8 ]. The median of three consecutive measurements was taken into consideration [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Bleb-Independent Glaucoma Surgery to Activate the Uveolymphatic Route of Non-Trabecular Aqueous Humor Outflow: Short-Term Clinical and OCT Results

Kumar

Zaalan

Беззаботнов³

et al. 2022

Vision

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The deep sclerectomy technique was modified to enhance aqueous humor (AH) outflow via the non-trabecular pathway. A pilot study was carried out to assess its safety and effectiveness. Thirty-eight patients were under observation. After superficial scleral flap (4 × 4 mm), deep scleral layers were divided into three parts by three parallel-to-limbus incisions. Deep sclerectomy without creating a window in the Descemetes’ membrane was carried out in the distal part. A collagen implant was placed under the sclera of the remaining two parts with one end in the intrascleral pool. The third proximal part was excised to expose the uvea and implant. A Nd:YAG laser trabeculotomy at the surgery site was made on postoperative days 7–10. Outcome measures were IOP change, use of hypotensive medication(s), complications, and the need for a second surgery. At six months, the mean IOP decreased from 29.1 ± 9.2 mm Hg to 14.0 ± 4.3 mm Hg (p = 1.4 × 10−9); hypotensive medication use reduced from 2.9 ± 0.9 to 0.6 ± 1.0 (p = 1.3 × 10−10); complete success was achieved in 68.4% of cases and partial success was achieved in 31.6% of cases. Intraoperative and postoperative complications were rare and manageable. The OCT of the surgery site revealed the absence of bleb in all cases. Lymphatic vessels with characteristic bicuspid valves in their lumen were detected in conjunctiva near the operation site and over it in 32 patients. IOP decrease in the proposed technique was achieved by activation of the uveolymphatic route of AH outflow.

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Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Cited by 6 publications

References 29 publications

Accuracy and Reliability of Self-measured Intraocular Pressure in Glaucoma Patients Using the iCare HOME Tonometer

Accuracy and Reliability of Self-measured Intraocular Pressure in Glaucoma Patients Using the iCare HOME Tonometer

Clinical and Optical Coherence Tomography Evidence of Aqueous Humor Flow from the Suprachoroidal Space to Conjunctival Lymphatics

Bleb-Independent Glaucoma Surgery to Activate the Uveolymphatic Route of Non-Trabecular Aqueous Humor Outflow: Short-Term Clinical and OCT Results

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