Use of disposable prism tonometry in routine clinical practice

Salvi, Sachin M.; Sivakumar, Subramaniam; Sidiki, Sikander S

doi:10.1038/sj.eye.6701633

Cited by 20 publications

(16 citation statements)

References 5 publications

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“…While our results were in line with those studies, we found some limitations in the study design, as these studies tested either Tonosafe 17 or Tonoshield 12 against the standard Goldmann applanation tonometry and they did not compare one prism vs the other. For this reason, we conducted a method analysis that compared three methods instead of two.…”

Section: Discussionsupporting

confidence: 89%

A comparison of clinical performance between disposable and Goldmann tonometers

Maino

Uddin

Tullo

2005

Eye

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Purpose Applanation tonometry as performed in routine clinical practice is a significant potential vehicle for cross-infection particularly in an emergency eye care setting. The aim of this study is to evaluate the accuracy and reliability of three single-use devices (Tonoshield, Tonosafe, Tonojet) as an alternative to standard Goldmann prisms in an emergency eye department.Methods All patients attending the eye casualty at the Manchester Royal Eye Hospital for a period of 4 months who required intraocular pressure measurement were eligible for this prospective study. Exclusion criteria were: age below 18 years, corneal anomalies that might affect measurement, and refusal to participate. After taking informed consent, the patient was examined by one experienced nurse practitioner, who measured the intraocular pressure three times. In the first part of the study, we compared the standard Goldmann prism vs Tonoshield and Tonosafe prisms, while for the second part of the study we used standard Goldmann, Tonosafe, and Tonojet prisms. Agreement and repeatability tests were carried out on separate samples. Results Tonosafe and Tonojet correlated well with standard Goldmann tonometry (Po0.001), while the measurements obtained with Tonoshield were higher, especially for raised intraocular pressure measurements. Tonojet and Tonosafe measurements were more reproducible than Tonoshield measurements.Conclusions This study shows that Tonosafe and Tonojet are accurate and reliable alternatives to standard Goldmann tonometry.

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Section: Discussionsupporting

confidence: 89%

A comparison of clinical performance between disposable and Goldmann tonometers

Maino

Uddin

Tullo

2005

Eye

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“…29 Unlike the disposable tonometer shield (eg Tonoshield TM ), disposable acrylic tonometer prisms (eg Tonosafe TM and Tonojet TM ) have been found to correlate well with standard Goldmann tonometry measurements in the general and emergency eye clinic setting. 30,31 However, a recent study has found the Tonosafe TM prism to be less accurate in a glaucoma population, particularly where the intraocular pressure exceeds 25 mm Hg. 32 Furthermore, the use of a disposable tonometer does not completely eliminate the risk of cross-contamination between eyes due to manual handling of the tonometer prism 33 and has cost implications.…”

Section: Discussionmentioning

confidence: 99%

“…32 Furthermore, the use of a disposable tonometer does not completely eliminate the risk of cross-contamination between eyes due to manual handling of the tonometer prism 33 and has cost implications. 30 Currently, in the UK, there appears to be great disparity between current tonometer disinfection practice and published international recommendations, with some institutions using non-evidence-based practices, which may render patients susceptible to transmissible ocular infections and possibly systemic disease. This survey highlights the need for the development of tonometer disinfection guidelines in the UK.…”

Section: Discussionmentioning

confidence: 99%

Tonometer disinfection practice in the United Kingdom: A national survey

Hillier

Kumar

2007

Eye

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Purpose: To assess current tonometer disinfection practice in the UK, and compare with published recommendations. Methods: Every ophthalmology unit with training recognition in the UK was contacted (n ¼ 155). A senior nurse at each institution completed a telephone questionnaire regarding local tonometer disinfection practice. Results: The response rate was 100%. Thirty-five units (23%) reported exclusive use of disposable tonometer heads and were excluded from further analysis. One hundred and twenty units (77%) used either reusable or a combination of reusable and disposable tonometer heads. Where reusable heads were used, 80 units (67%) immersed them in a chlorine-based solution such as sodium hypochlorite or sodium dichloroisocyanurate.

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“…Recent studies [48][49][50] demonstrate the accuracy and reliability of disposable prism tonometry when compared to the gold standard of Goldmann tonometry. Inferences from these studies indicate within the advantages of disposable prisms, a short learning curve, ease of use, and reproducibility of results.…”

Section: Eyementioning

confidence: 99%

Tonometers and infectious risk: myth or reality? Efficacy of different disinfection regimens on tonometer tips

Cillino

Casuccio

Giammanco

et al. 2006

Eye

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Purpose To evaluate the adequacy of common disinfection regimens for disposable tonometer tips and assess if disinfection of reusable prisms or the use of disposable tips is preferable. Methods We used disposable tonometer tips, using the same material and tip diameter of standard Goldmann tonometer prism. Strains of Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilis and Candida albicans were tested according to the European standard guidelines for disinfectants test. Antimicrobial effectiveness of the following disinfection practices has been assessed: dry wipe, Minuten wipes (Alpro s ), soaking in 3% hydrogen peroxide, 0.5% benzalkonium chloride, and 0.5% Pantasept s for 1, 5, and 15 min. All tests have been performed three times and all conditions tested in duplicate.Results Dry wiping and 1 min soak in 3% hydrogen peroxide were ineffective on all microrganisms. Minuten wipes, 1 min soak in 0.5% benzalkonium chloride or 3% hydrogen peroxide were ineffective on B. subtilis. 0.5% Pantasept s soak was effective in 1 min for all microrganisms tested, whereas 3% hydrogen peroxide and 0.5% benzalkonium chloride soaks were effective when performed for at least 5 min. B. subtilis was the most resistant organism to disinfectant regimes at 1 min time.Conclusions Results of our study demonstrate a relative disinfection efficacy for the different evaluated regimens, provided that correct exposure times are adopted for the chosen disinfectants, a condition difficult to ensure in a busy clinic setting. We conclude that disposable prism tonometry provides a safe alternative to Goldmann tonometry.

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Use of disposable prism tonometry in routine clinical practice

Cited by 20 publications

References 5 publications

A comparison of clinical performance between disposable and Goldmann tonometers

A comparison of clinical performance between disposable and Goldmann tonometers

Tonometer disinfection practice in the United Kingdom: A national survey

Tonometers and infectious risk: myth or reality? Efficacy of different disinfection regimens on tonometer tips

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