Dynamic contour tonometry versus Goldmann applanation tonometry: a comparative study

Pache, Mona; Wilmsmeyer, S.; Lautebach, S.; Funk, Jens

doi:10.1007/s00417-005-1124-y

Cited by 96 publications

(105 citation statements)

References 31 publications

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“…[20][21][22][23][24] In our series, GAT showed a significant correlation with CCT, contrary to DCT. In accordance with other studies, 6,11,17,25 we observed that CCT affects GAT IOP measurements. We also demonstrated that GAT measurements are lower than DCT readings in corneas with CCTs o600 mm, but they become higher in thick corneas (CCT4600 mm).…”

Section: Discussionsupporting

confidence: 93%

Influence of age, central corneal thickness, and quality score on dynamic contour tonometry

Jordão

Lupinacci

Ferreira

et al. 2008

Eye

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Aims To compare the IOP measurements obtained with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT), and to analyse the influence of central corneal thickness (CCT) and age on both measurements, and the influence of the quality score on DCT readings. Methods A total of 500 healthy subjects with no prior history of glaucoma or ocular hypertension (age: 7-86 years) were consecutively recruited. GAT, DCT, and CCT measurements were obtained from both eyes of each individual, in this order, by three observers. The mean of five CCT measurements was used for analysis. DCT measurements were accepted when quality scores varied between 1 (higher quality) and 3 (lower quality). Results Mean DCT measurements were 3.2 mmHg higher than GAT readings. CCT values varied between 449 and 653 lm. IOP measured by GAT correlated strongly with CCT (r 2 ¼ 0.28, P ¼ o0.001), whereas DCT readings correlated poorly with CCT (r 2 ¼ 0.01, P ¼ 0.017). Both DCT (r 2 ¼ o0.01, P ¼ 0.044) and GAT (r 2 ¼ 0.01, P ¼ o0.001) measurements correlated poorly with age. Bland-Altmann analysis revealed disagreement between DCT and GAT readings, with 95% confidence intervals of ±6.7 mmHg. Quality scores for DCT measurements were 1 (n ¼ 369, 36.9%), 2 (n ¼ 340, 34.0%), and 3 (n ¼ 291, 29.1%). DCT readings with quality score of 3 (18.8 ± 3.4 mmHg) were significantly higher than those with quality scores of 1 (16.7±2.9 mmHg) and 2 (17.4±2.9 mmHg; P ¼ o0.001). Conclusions DCT is not influenced by CCT, unlike GAT. Both DCT and GAT measurements are not influenced by age. DCT measurements with lower quality scores are associated with higher readings.

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Section: Discussionsupporting

confidence: 93%

Influence of age, central corneal thickness, and quality score on dynamic contour tonometry

Jordão

Lupinacci

Ferreira

et al. 2008

Eye

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“…Most studies have found DCT readings to be higher than GAT. 25,26 In contrast, a recent study on African-American subjects did not find a significant difference in mean IOPs between GAT and DCT; with mean DCT IOP only 0.4 mm Hg higher than GAT. 27 This study found no proportional bias between the GAT and DCT readings.…”

Section: Discussionmentioning

confidence: 70%

Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Carbonaro

Andrew

Mackey

et al. 2010

Eye

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Purpose The purpose of this study was to compare the reliability of the 'gold standard' Goldmann applanation tonometer (GAT), with that of the ocular response analyser (ORA), and the dynamic contour tonometer (DCT). Patients and methods A total of 694 subjects were recruited to participate from the TwinsUK (UK Adult Twin Registry) at St Thomas' Hospital, London. Intraocular pressure (IOP) was measured using GAT, ORA, and the DCT. The agreement between the three methods was assessed using the Bland-Altman method. Repeatability coefficients and coefficient of variation between first and second readings of the same eye were used to assess reliability. Results Mean age was 57.5 years (SD, 13.1; range, 16.1-88.5). The mean IOPs, calculated using the mean of two readings from the right eye were as follows: Goldmann (GAT), 14.1 ± 2.8 mm Hg; IOPg (ORA), 15.9 ± 3.2 mm Hg; IOPcc (ORA), 16.6 ± 3.2 mm Hg; and DCT, 16.9 ± 2.7 mm Hg. The 95% limits of agreement were for ORA (IOPcc): GAT, À2.07 to 7.18 mm Hg; for DCT: GAT, À0.49 to 6.21 mm Hg; and for DCT: ORA (IOPcc), À3.01 to 4.85 mm Hg. Coefficients of variation for the three tonometers were GAT, 8.3%; ORA, 8.2%; DCT, 6.3%. The repeatability coefficients were 3.4 mm Hg for GAT, 3.57 mm Hg for ORA and 3.09 mm Hg for DCT. GAT and ORA (IOPg) readings showed a positive correlation with central corneal thickness (Po0.005). Conclusions This study found similar reliability in all three tonometers. Bland-Altman plots showed the three instruments to have 95% limits of agreement outside the generally accepted limits, which means they are not interchangeable. GAT measurements were found to be significantly lower than the two newer instruments.

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“…This finding is in agreement with other studies that showed that the difference between the tonometers declined as CCT increased. 36,41 On the contrary, only Barleon et al 35 observed that the difference between the two instruments was greatest in eyes with lower IOP value, gradually lessening as IOP increased. Considering the values recorded in our limited study population, we found an inverse association between DCT and GAT for CCT values above 620 mm and IOP values above 24 mmHg.…”

Section: Discussionmentioning

confidence: 98%

“…Similar results, in spite of different mean values, have been reported by previous investigations. 16,[19][20][21][23][24][25][26][27][28][29][30][31]35,36 The DIOP between DCT and GAT readings was higher in healthy than in glaucomatous eyes, either with open-angle or angleclosure phenotypes (Table 1). The same outcome has been found by analysing IOP measurements obtained by DCT and GAT in different groups of subjects with the same CCT value, except for POAG subjects with thinner corneas.…”

Section: Discussionmentioning

confidence: 99%

“…16 DCT was designed to be largely independent of structural properties of the cornea and to eliminate most of the systematic errors arising from physiological variables of the eye, which render GAT less accurate. 17 Some recent studies compared the performance of the new device against other tonometers [18][19][20][21][22] considering either the influence of pachymetry on IOP readings [23][24][25][26] or the impact of refractive surgery as a source of errors in applanation tonometry. [27][28][29][30] Only two studies evaluated ocular structural factors other than pachymetry influencing IOP measurements in healthy subjects 31 or African American subjects.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Goldmann applanation tonometry and dynamic contour tonometry in healthy and glaucomatous eyes

Ceruti

Morbio

Marraffa

et al. 2008

Eye

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Purpose To compare the measurements of intraocular pressure (IOP) with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) in healthy and glaucomatous eyes and to evaluate the influence of corneal thickness (CCT), corneal curvature (CC), axial length (AL), and age on these tonometric alternatives. Methods Three hundred eyes of 100 healthy subjects, 100 patients with primary open angle glaucoma, and 100 patients with primary angle-closure glaucoma underwent IOP evaluation with DCT and GAT, and measurements of CCT, CC, and AL. Bland-Altman plots were used to evaluate the agreement between tonometers. Regression analysis was used to evaluate the influence of ocular structural factors on IOP measurements obtained with both tonometers. Results Bland-Altman plots indicated that the 95% limits of agreement between tonometers were À1.4 to 6.6 mmHg. DCT values measured 2.6 ± 1.9 mmHg higher than GAT readings (Po0.001). The mean IOP difference between DCT and GAT (DIOP) was higher in healthy than in glaucomatous eyes and the magnitude of difference increased with increasing CCT. A significant reduction of DIOP with an increase in both CCT (Po0.001) and IOP values (Po0.001) was found. Regression analysis showed no effect of CC, AL, and age on both DCT and GAT readings. In contrast to GAT (Po0.001), DCT measurements were not influenced by CCT (P ¼ 0.43).Conclusions IOP readings obtained by DCT were higher and less affected by CCT than those by GAT. The DIOP was higher in healthy than in glaucomatous eyes and decreased in relation to increased CCT and IOP values.

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Dynamic contour tonometry versus Goldmann applanation tonometry: a comparative study

Abstract: In eyes with normal corneas, DCT allows suitable and reliable IOP measurements which are in good concordance with GAT. Comparison of DCT with intracameral manometry is desirable in the future.

Cited by 96 publications

References 31 publications

Influence of age, central corneal thickness, and quality score on dynamic contour tonometry

Influence of age, central corneal thickness, and quality score on dynamic contour tonometry

Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Comparison of Goldmann applanation tonometry and dynamic contour tonometry in healthy and glaucomatous eyes

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