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Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes.
Br J Ophthalmol 2008; 92(12):1661-5BJ

Abstract

AIM

The aim of this study was to evaluate the practicality and accuracy of tonometers used in routine clinical practice for established keratoconus (KC).

METHODS

This was a prospective study of 118 normal and 76 keratoconic eyes where intraocular pressure (IOP) was measured in random order using the Goldman applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), Reichert ocular response analyser (ORA) and TonoPen XL tonometer. Corneal hysteresis (CH) and corneal resistance factor (CRF), as calculated by the ORA, were recorded. Central corneal thickness (CCT) was measured using an ultrasound pachymeter.

RESULTS

The difference in IOP values between instruments was highly significant in both study groups (p<0.001). All other IOP measures were significantly higher than those for GAT, except for the Goldmann-correlated IOP (average of the two applanation pressure points) (IOPg) as measured by ORA in the control group and the CH-corrected IOP (corneal-compensated IOP value) (IOPcc) measures in the KC group. CCT, CH and CRF were significantly less in the KC group (p<0.001). Apart from the DCT, all techniques tended to measure IOP higher in eyes with thicker corneas.

CONCLUSION

The DCT and the ORA are currently the most appropriate tonometers to use in KC for the measurement of IOPcc. Corneal factors such as CH and CRT may be of more importance than CCT in causing inaccuracies in applanation tonometry techniques.

Authors+Show Affiliations

Birmingham and Midland Eye Centre, City Hospital, Birmingham B18 7QH, UK. soozmollan@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article
Multicenter Study

Language

eng

PubMed ID

18757471

Citation

Mollan, S P., et al. "Accuracy of Goldmann, Ocular Response Analyser, Pascal and TonoPen XL Tonometry in Keratoconic and Normal Eyes." The British Journal of Ophthalmology, vol. 92, no. 12, 2008, pp. 1661-5.
Mollan SP, Wolffsohn JS, Nessim M, et al. Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes. Br J Ophthalmol. 2008;92(12):1661-5.
Mollan, S. P., Wolffsohn, J. S., Nessim, M., Laiquzzaman, M., Sivakumar, S., Hartley, S., & Shah, S. (2008). Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes. The British Journal of Ophthalmology, 92(12), pp. 1661-5. doi:10.1136/bjo.2007.136473.
Mollan SP, et al. Accuracy of Goldmann, Ocular Response Analyser, Pascal and TonoPen XL Tonometry in Keratoconic and Normal Eyes. Br J Ophthalmol. 2008;92(12):1661-5. PubMed PMID: 18757471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of Goldmann, ocular response analyser, Pascal and TonoPen XL tonometry in keratoconic and normal eyes. AU - Mollan,S P, AU - Wolffsohn,J S, AU - Nessim,M, AU - Laiquzzaman,M, AU - Sivakumar,S, AU - Hartley,S, AU - Shah,S, Y1 - 2008/08/29/ PY - 2008/9/2/pubmed PY - 2009/1/8/medline PY - 2008/9/2/entrez SP - 1661 EP - 5 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 92 IS - 12 N2 - AIM: The aim of this study was to evaluate the practicality and accuracy of tonometers used in routine clinical practice for established keratoconus (KC). METHODS: This was a prospective study of 118 normal and 76 keratoconic eyes where intraocular pressure (IOP) was measured in random order using the Goldman applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), Reichert ocular response analyser (ORA) and TonoPen XL tonometer. Corneal hysteresis (CH) and corneal resistance factor (CRF), as calculated by the ORA, were recorded. Central corneal thickness (CCT) was measured using an ultrasound pachymeter. RESULTS: The difference in IOP values between instruments was highly significant in both study groups (p<0.001). All other IOP measures were significantly higher than those for GAT, except for the Goldmann-correlated IOP (average of the two applanation pressure points) (IOPg) as measured by ORA in the control group and the CH-corrected IOP (corneal-compensated IOP value) (IOPcc) measures in the KC group. CCT, CH and CRF were significantly less in the KC group (p<0.001). Apart from the DCT, all techniques tended to measure IOP higher in eyes with thicker corneas. CONCLUSION: The DCT and the ORA are currently the most appropriate tonometers to use in KC for the measurement of IOPcc. Corneal factors such as CH and CRT may be of more importance than CCT in causing inaccuracies in applanation tonometry techniques. SN - 1468-2079 UR - https://www.unboundmedicine.com/medline/citation/18757471/Accuracy_of_Goldmann_ocular_response_analyser_Pascal_and_TonoPen_XL_tonometry_in_keratoconic_and_normal_eyes_ L2 - http://bjo.bmj.com/cgi/pmidlookup?view=long&amp;pmid=18757471 DB - PRIME DP - Unbound Medicine ER -