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Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty.
Eye (Lond). 2011 May; 25(5):642-50.E

Abstract

PURPOSE

To compare intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT) and iCare tonometry in normal and post-keratoplasty corneas and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP.

METHODS

This prospective cross-sectional study included one eye of 101 subjects with normal corneas (58 healthy subjects, 43 glaucoma); and 90 post-keratoplasty patients: 34 penetrating keratoplasties (PK); 20 automated-lamellar-therapeutic keratoplasties (ALTK); 19 Descemet-stripping-automated-endothelial keratoplasties (DSAEK); 17 edematous grafts. All subjects underwent GAT and iCare IOP measurements in random order, and CCT, CC, and CA evaluation. The Bland-Altman method and multivariate regression analysis were used to assess inter-tonometer agreement and the influence of CCT, CC, and CA on IOP.

RESULTS

iCare significantly underestimated IOP in all groups compared with GAT (GAT minus iCare of 3.5±3.5 mm Hg, P<0.001), but overestimated IOP in the edematous grafts (GAT minus iCare of -6.5±1.9 mm Hg, P<0.001). In normal corneas, both tonometer measurements were directly related to CCT values; iCare readings appeared inversely related to CC. There was no significant relationship between IOP and CCT, CC and CA in post-keratoplasty eyes, except between CC and iCare measurements for PK eyes.

CONCLUSIONS

The agreement between GAT and iCare was clinically acceptable in control, ALTK and DSAEK groups, and poor in PK and edematous grafts eyes. In normal corneas, GAT was significantly affected by CCT; iCare was influenced by CCT and CC. The iCare appeared less influenced by corneal edema when compared with GAT. High IOP readings taken with both tonometers in grafts should raise suspicion of true elevated IOP.

Authors+Show Affiliations

Department of Ophthalmology, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, S.O.C. Oculistica, piazzale S. Maria della Misericordia 15, Udine, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21436848

Citation

Salvetat, M L., et al. "Comparison of iCare Tonometer and Goldmann Applanation Tonometry in Normal Corneas and in Eyes With Automated Lamellar and Penetrating Keratoplasty." Eye (London, England), vol. 25, no. 5, 2011, pp. 642-50.
Salvetat ML, Zeppieri M, Miani F, et al. Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty. Eye (Lond). 2011;25(5):642-50.
Salvetat, M. L., Zeppieri, M., Miani, F., Tosoni, C., Parisi, L., & Brusini, P. (2011). Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty. Eye (London, England), 25(5), 642-50. https://doi.org/10.1038/eye.2011.60
Salvetat ML, et al. Comparison of iCare Tonometer and Goldmann Applanation Tonometry in Normal Corneas and in Eyes With Automated Lamellar and Penetrating Keratoplasty. Eye (Lond). 2011;25(5):642-50. PubMed PMID: 21436848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of iCare tonometer and Goldmann applanation tonometry in normal corneas and in eyes with automated lamellar and penetrating keratoplasty. AU - Salvetat,M L, AU - Zeppieri,M, AU - Miani,F, AU - Tosoni,C, AU - Parisi,L, AU - Brusini,P, Y1 - 2011/03/25/ PY - 2011/3/26/entrez PY - 2011/3/26/pubmed PY - 2011/8/25/medline SP - 642 EP - 50 JF - Eye (London, England) JO - Eye (Lond) VL - 25 IS - 5 N2 - PURPOSE: To compare intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT) and iCare tonometry in normal and post-keratoplasty corneas and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), and corneal astigmatism (CA) on IOP. METHODS: This prospective cross-sectional study included one eye of 101 subjects with normal corneas (58 healthy subjects, 43 glaucoma); and 90 post-keratoplasty patients: 34 penetrating keratoplasties (PK); 20 automated-lamellar-therapeutic keratoplasties (ALTK); 19 Descemet-stripping-automated-endothelial keratoplasties (DSAEK); 17 edematous grafts. All subjects underwent GAT and iCare IOP measurements in random order, and CCT, CC, and CA evaluation. The Bland-Altman method and multivariate regression analysis were used to assess inter-tonometer agreement and the influence of CCT, CC, and CA on IOP. RESULTS: iCare significantly underestimated IOP in all groups compared with GAT (GAT minus iCare of 3.5±3.5 mm Hg, P<0.001), but overestimated IOP in the edematous grafts (GAT minus iCare of -6.5±1.9 mm Hg, P<0.001). In normal corneas, both tonometer measurements were directly related to CCT values; iCare readings appeared inversely related to CC. There was no significant relationship between IOP and CCT, CC and CA in post-keratoplasty eyes, except between CC and iCare measurements for PK eyes. CONCLUSIONS: The agreement between GAT and iCare was clinically acceptable in control, ALTK and DSAEK groups, and poor in PK and edematous grafts eyes. In normal corneas, GAT was significantly affected by CCT; iCare was influenced by CCT and CC. The iCare appeared less influenced by corneal edema when compared with GAT. High IOP readings taken with both tonometers in grafts should raise suspicion of true elevated IOP. SN - 1476-5454 UR - https://www.unboundmedicine.com/medline/citation/21436848/Comparison_of_iCare_tonometer_and_Goldmann_applanation_tonometry_in_normal_corneas_and_in_eyes_with_automated_lamellar_and_penetrating_keratoplasty_ L2 - http://dx.doi.org/10.1038/eye.2011.60 DB - PRIME DP - Unbound Medicine ER -