Goldmann versus Disposable Applanation Tonometer Tips in Glaucoma Patients and Normal Subjects

Eldaly, Mohamed A.

doi:10.3109/02713683.2015.1015144

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…28 Instead, soaking the tips in dilute sodium hypochlorite (beach) has been shown to be most effective, although it can cause damage to tips over time 28 and failure to adequately rinse away the bleach before use could potentially cause corneal burns. Given these limitations of logistics and risk, most AGS members report using disposable Goldmann biprism tips 27 which have been associated with higher intermeasurement variability than nondisposable tips, 29,30 introducing yet another source of error to Goldmann tonometry in the COVID-19 era.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Realini

McMillan

Gross

et al. 2021

Journal of Glaucoma

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Precis: In a trio of prospective studies, the iCare rebound tonometer demonstrated significantly lower test-retest variability than Goldmann tonometry with good interoperator and interdevice reproducibility, supporting its value in monitoring intraocular pressure (IOP) changes over time. Purpose: The purpose of this study was to characterize intraoperator and interoperator and interdevice reliability of IOP measurements with rebound tonometry (RT, ic100). Methods: Three prospective cross-sectional studies were conducted in distinct sample of adult patients with established glaucoma, suspected glaucoma, or no glaucoma at the West Virginia University Eye Institute. Participants in study 1 underwent 5 RT measurements in one randomly selected eye and 5 Goldmann tonometry measurements in the fellow eye by 1 operator; intraoperator variability was compared using the F test. In study 2, 3 operators each obtained 3 RT measurements in participants in randomized operator order. In study 3, a single operator collected 3 measurements each with 3 RTs in randomized device order. Between-operator and between-device reproducibility were characterized using intraclass correlation coefficients (ICCs). Results: Overall, 28, 19, and 25 subjects participated in the 3 respective studies. Within-subject variance across subjects was 0.757 in RT measurements and 2.471 in Goldmann measurements (P=0.0035). Interoperator reproducibility of RT measurements was good in both eyes [ICC for right eyes 0.78, 95% confidence interval (CI): 0.60-0.85; ICC for left eyes 0.75, 95% CI: 0.50-0.83]. Interdevice reproducibility of RT measurements was good approaching excellent (ICC for right eyes 0.87, 95% CI: 0.83-0.90; ICC for left eyes 0.89, 95% CI: 0.86-0.91). Conclusions: The RT’s lower measurement variability and good interoperator and interdevice reproducibility suggest that it can characterize IOP changes over time more robustly than Goldmann tonometry, aiding clinicians in assessing the effectiveness of glaucoma therapy and the consistency of IOP control.

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Section: Discussionmentioning

confidence: 99%

Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Realini

McMillan

Gross

et al. 2021

Journal of Glaucoma

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“…However, it is an invasive operation, as this method can only be applied in experimental research (10). In clinical applications, GAT is recognized as the global reference standard of tonometry (11–14). With relatively high accuracy, the GAT has become a standard to test the reliability of other tonometers in clinical applications.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

Gao

Liu

Zhao

et al. 2017

Experimental and Therapeutic Medicine

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Tonometry is a fundamental procedure in routine ophthalmologic examination. Although regarded as the reference standard, the Goldmann applanation tonometer (GAT) has its limitations. A new portable alternative to the GAT is the iCare rebound tonometer (RT). The aim of the present study was to compare the intraocular pressure (IOP) results obtained using the RT and GAT and then correlate the results with the central corneal thickness (CCT). Moreover, the tolerability and safety of the RT were evaluated. The IOP of 336 patients (672 eyes) was determined by the RT and GAT. The patients were divided into three groups (group A, 7–15 mmHg, n=74; group B, 16–22 mmHg, n=218; and group C, 23–50 mmHg, n=44), based on the GAT IOP readings. Pachymetry and slit lamp inspection were also performed. To establish an agreement between the devices, a Bland-Altman analysis and paired t-test were performed. The correlation between CCT and IOP readings obtained by the two devices were assessed using linear regression correlation analysis. The mean IOP values of the RT and the GAT were 18.30±5.10 and 18.52±4.46 mmHg, respectively. There were no significant differences between them (t=−1.31, P=0.19). The 95% confidence interval of the differences between the two devices was −5.80–6.24 mmHg. The RT readings are correlated well with those of GAT (r=0.806, P=0.001). However, the RT measurements were significantly (t=−2.84, P=0.007) lower (−1.66±3.87 mmHg) than those obtained with GAT when GAT ≥23 mmHg. Both the RT (r=0.390, P=0.001) and the GAT (r=0.191, P=0.001) showed positive correlations with CCT. The IOP measurement with RT was well tolerated. None of the corneal epithelial defects was detected and all subjects denied discomfort. The RT is well tolerated and safe, and can be considered a reliable alternative to GAT for patients in a low to moderate IOP range. However, in patients with high IOP values, the measurements obtained with RT did not correlate well with those obtained by GAT. The RT readings are influenced more by CCT compared to GAT.

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“…There are several important considerations in the use of disposable tips. Eldaly [ 32 ] found that surface irregularities were relatively common in the Luneau prisms. In their study, they inspected the prisms prior to use and found that 14 of 189 disposable tips had to be discarded because of the presence of surface irregularities.…”

Section: Goldmann Applanation Tonometrymentioning

confidence: 99%

“…range of 0.1-0.5 mmHg [26][27][28][29][30][31]. Studies comparing the Luneau Tonojet to reusable tip GAT found a mean IOP difference of 0.4-2.35 mmHg [26,32,33].…”

Section: Goldmann Applanation Tonometrymentioning

confidence: 99%

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How should we measure intraocular pressure in the era of coronavirus disease 2019? Balancing infectious risk, cleaning requirements, and accuracy

Petersen

Chen

2022

Current Opinion in Ophthalmology

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Purpose of review Accurate and precise measurement of intraocular pressure (IOP) is a vitally important component of the ophthalmic examination. There are multiple methods of tonometry, each of which has considerations in light of the ongoing severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. This review discusses these considerations and compares various tonometer methods with the gold standard of Goldmann applanation tonometry (GAT). Recent findings The SARS-CoV-2 virus may spread via droplets, microaerosols, or direct contact in the ophthalmology clinic. Tonometry poses a high risk of contamination. The accuracy and reliability of various methods of tonometry with single-use disposable equipment has been compared with Goldmann applanation tonometry. Summary Goldmann applanation tonometry with disposable applanation tips, Tono-pen, and iCare employ single use tips to decrease the risk of cross-contamination of infectious agents. Review of the literature demonstrates good correlation between these devices and GAT, although the published level of agreement between devices varies.

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Goldmann versus Disposable Applanation Tonometer Tips in Glaucoma Patients and Normal Subjects

Abstract: The disagreement between disposables and standard Goldmann tips followed different patterns in glaucoma patients when compared with normal subjects. The use of the Goldmann tip is advised with glaucoma patients.

Cited by 4 publications

References 13 publications

Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Assessing the Reliability of Intraocular Pressure Measurements Using Rebound Tonometry

Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer

How should we measure intraocular pressure in the era of coronavirus disease 2019? Balancing infectious risk, cleaning requirements, and accuracy

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