Clinical Comparison of Ocular Blood Flow Tonometer, Tonopen, and Goldmann Applanation Tonometer for Measuring Intraocular Pressure in Postkeratoplasty Eyes

Rao, Veena; Gnanaraj, Lawrence; Mitchell, Keith; Figueiredo, Francisco C

doi:10.1097/00003226-200111000-00011

Cited by 43 publications

(32 citation statements)

References 14 publications

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“…27 In accordance with previous studies, 28,29 differences that exceed these limits tend to be clinically relevant for diagnosis, follow-up, and treatment.…”

Section: Discussionsupporting

confidence: 85%

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Salvetat

Zeppieri

Miani

et al. 2011

Eye

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Purpose To compare intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT) and iCare tonometry in normal and post-keratoplasty corneas and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP. Methods This prospective cross-sectional study included one eye of 101 subjects with normal corneas (58 healthy subjects, 43 glaucoma); and 90 post-keratoplasty patients: 34 penetrating keratoplasties (PK); 20 automated-lamellar-therapeutic keratoplasties (ALTK); 19 Descemet-stripping-automatedendothelial keratoplasties (DSAEK); 17 edematous grafts. All subjects underwent GAT and iCare IOP measurements in random order, and CCT, CC, and CA evaluation. The Bland-Altman method and multivariate regression analysis were used to assess inter-tonometer agreement and the influence of CCT, CC, and CA on IOP.Results iCare significantly underestimated IOP in all groups compared with GAT (GAT minus iCare of 3.5±3.5 mm Hg, Po0.001), but overestimated IOP in the edematous grafts (GAT minus iCare of À6.5 ± 1.9 mm Hg, Po0.001). In normal corneas, both tonometer measurements were directly related to CCT values; iCare readings appeared inversely related to CC. There was no significant relationship between IOP and CCT, CC and CA in post-keratoplasty eyes, except between CC and iCare measurements for PK eyes. Conclusions The agreement between GAT and iCare was clinically acceptable in control, ALTK and DSAEK groups, and poor in PK and edematous grafts eyes. In normal corneas, GAT was significantly affected by CCT; iCare was influenced by CCT and CC. The iCare appeared less influenced by corneal edema when compared with GAT. High IOP readings taken with both tonometers in grafts should raise suspicion of true elevated IOP.

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“…27 In accordance with previous studies, 28,29 differences that exceed these limits tend to be clinically relevant for diagnosis, follow-up, and treatment.…”

Section: Discussionsupporting

confidence: 85%

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Salvetat

Zeppieri

Miani

et al. 2011

Eye

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“…The Tonopen XL is a portable tonometer that permits accurate measurements in varied positions. 12 Two averaged readings were taken per eye in each position. Patients then underwent infrared pupillometry.…”

Section: Protocolmentioning

confidence: 99%

Effect of Posture on Blood and Intraocular Pressures in Multiple System Atrophy, Pure Autonomic Failure, and Baroreflex Failure

et al. 2003

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Background-Intraocular pressure (IOP) may be partially under systemic vascular control. This study examined whether a correlation exists between blood and intraocular pressures in patients with autonomic dysfunction. Methods and Results-Eleven patients with 3 types of confirmed autonomic dysfunction (multiple system atrophy, pure autonomic failure, and baroreflex failure) were compared with age-and gender-matched controls and had IOP, systolic blood pressure, diastolic blood pressure, heart rates, and calculated mean arterial pressures (MAP) and mean ocular perfusion pressures (MOPP) measured in the supine, sitting, and standing positions. Data were analyzed with a general linear model repeated-measures ANOVA. All pressures for patients showed a dramatic decline (PϽ0.001) from supine to standing (MAP Ϫ31Ϯ14 mm Hg; IOP Ϫ6Ϯ3 mm Hg; MOPP Ϫ25Ϯ14 mm Hg) compared with controls (MAP ϩ4Ϯ7 mm Hg; IOP Ϫ1Ϯ2 mm Hg; MOPP ϩ6Ϯ7 mm Hg). There was no significant change in heart rate from supine to standing for patients compared with controls (Pϭ0.648). Within both the multiple system atrophy (nϭ5) and pure autonomic failure (nϭ4) groups, all initial pressures were similar to control pressures in the supine position, whereas patients with baroreflex failure (nϭ2) had higher mean pressures than respective controls in the supine position. Conclusions-In autonomic dysfunction, a large decrease in MAP correlated with a large decrease in IOP. These data suggest that the autonomic nervous system, perhaps through an influence on systemic blood pressure, has a significant role in IOP regulation.

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“…For the entire group of patients with corneal pathologies, the IOP measurement results for TP were just as accurate as those for the control group. Several other studies have reported similar results, with the TP yielding exact IOP values after penetrating keratoplasty [24] [25]. Nevertheless, these groups compared TP measurements of IOP to IOP values obtained by GAT, and not to direct intracameral readings.…”

Section: Discussionmentioning

confidence: 66%

“…When comparing TP to GAT, some authors found the Tono-Pen to underestimate or overestimate the IOP, with a particular trend toward overestimation at higher IOP values [20] [22] [23]. In patients who had undergone penetrating keratoplasty, both Shemesh and Rao found the TP to show good agreement with IOP values yielded by GAT [24] [25].…”

Section: Discussionmentioning

confidence: 99%

Dynamic Contour Tonometry, Tono-Pen XL<sup>®</sup>, and Goldmann Applanation Tonometry in Comparison to Intracameral Intraocular Pressure (IOP) Measurements in Patients with Corneal Pathologies

Neuburger¹,

Grosswendt²,

Lautebach³

et al. 2014

OJOph

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Purpose: The accuracy of Goldmann applanation tonometry (GAT) has been shown to depend on several biomechanical properties of the cornea. Newer tonometry devices (e.g., the Dynamic Contour Tonometer PASCAL ® [DCT] and the Tono-Pen ® XL [TP]) have been designed to accurately measure intraocular pressure (IOP) independent of corneal thickness (CCT) and pathology. This study investigates the influence of corneal pathologies on the accuracy of these IOP measuring devices, and compares this accuracy to that of direct intracameral IOP measurement. Methods: 8 eyes of 8 patients suffering from corneal pathologies scheduled for penetrating keratoplasty, and 10 eyes of 10 patients scheduled for cataract surgery (control group) were examined. Before surgery, the anterior chamber was cannulated at the temporal corneal limbus. In a closed system, the intraocular pressure (IOP) was directly set to 10, 20, and 30 mmHg with a manometric water column. Intraocular pressure measurements taken by GAT, DCT, and TP were compared to intracameral measurements obtained by a precision reference pressure sensor. Results: Control group: All three methods showed good agreement with the intracameral readings (mean deviation of all three devices, −0.9 mmHg). Group with corneal pathologies: The TP yielded the most exact IOP values in the group with corneal pathologies when taking all diagnoses into account. The mean deviations from the intracameral IOP measurements were −0.9 mmHg ± 3.2 mmHg (mean ± SD) for TP, −2.9 mmHg ± 3.3 mmHg for GAT, and −5.0 mmHg ± 7.9 mmHg for DCT. For bullous keratopathy, the most exact IOP readings were obtained by the TP (mean deviation −0.2 mmHg ± 3.5

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Clinical Comparison of Ocular Blood Flow Tonometer, Tonopen, and Goldmann Applanation Tonometer for Measuring Intraocular Pressure in Postkeratoplasty Eyes

Abstract: There was no significant difference in the overall accuracy of the OBF tonometer over the Tonopen versus the GAT. The OBF tonometer can be a useful alternative in measuring IOP in post-keratoplasty eyes.

Cited by 43 publications

References 14 publications

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Effect of Posture on Blood and Intraocular Pressures in Multiple System Atrophy, Pure Autonomic Failure, and Baroreflex Failure

Dynamic Contour Tonometry, Tono-Pen XL<sup>®</sup>, and Goldmann Applanation Tonometry in Comparison to Intracameral Intraocular Pressure (IOP) Measurements in Patients with Corneal Pathologies

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Clinical Comparison of Ocular Blood Flow Tonometer, Tonopen, and Goldmann Applanation Tonometer for Measuring Intraocular Pressure in Postkeratoplasty Eyes

Abstract: There was no significant difference in the overall accuracy of the OBF tonometer over the Tonopen versus the GAT. The OBF tonometer can be a useful alternative in measuring IOP in post-keratoplasty eyes.

Cited by 43 publications

References 14 publications

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty

Effect of Posture on Blood and Intraocular Pressures in Multiple System Atrophy, Pure Autonomic Failure, and Baroreflex Failure

Dynamic Contour Tonometry, Tono-Pen XL&lt;sup&gt;&#174;&lt;/sup&gt;, and Goldmann Applanation Tonometry in Comparison to Intracameral Intraocular Pressure (IOP) Measurements in Patients with Corneal Pathologies

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Dynamic Contour Tonometry, Tono-Pen XL<sup>®</sup>, and Goldmann Applanation Tonometry in Comparison to Intracameral Intraocular Pressure (IOP) Measurements in Patients with Corneal Pathologies