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

• 作者: Daniel B?hringer Florian Birnbaum Jens Friedrich Jordan Jens Funk Juliane Gro?wendt Matthias Neuburger Philip Maier Sonja Lautebach Thomas Reinhard
• 来源期刊: 眼科学期刊(英文)
• 学科: 医学
• 关键词: KERATOPLASTY IOP Measurement GOLDMANN Applanation TONOMETRY Dynamic Contour TONOMETRY Tono-Pen XL?
• 年，卷（期）: 2014,（2）
• 页码范围: 46-55
• 页数: 10页
• 分类号: R73

摘要

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 mmHg). The TP and GAT devices underestimated IOP in the patients with Fuchs’ endothelial dystrophy;all 3 devices underestimated adjusted IOP after keratoplasty. DCT showed the greatest deviations from adjusted IOP in the case of non-herpetic scars. In the control group, none of the devices showed a statistically relevant dependency on CCT. Nevertheless, in the gro