Comparison of Intraocular Pressure Using Goldmann's Applanation Tonometer as the ‎Current‏ ‏Standard of Clinics with Five Different Tonometers in Healthy People

Document Type : Original Article

Authors

1 Rehabilitation Science Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

2 Department of Optometry, School of Rehabilitation Sciences, Zahedan University of Medical Sciences, Zahedan, Iran.

3 Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

5 Eye Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

6 Cornea Research Center, Khatam‐Al‐Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Optometry, Faculty of Rehabilitation Sciences, Zahedan University of Medical Sciences, Zahedan, Iran

Abstract

Purpose:
To compare the intraocular pressure (IOP) measured with the Goldmann tonometer as the current standard of clinics with five different tonometers in healthy people, and to investigate the effect of corneal thickness and biomechanical properties on measurements.
Methods:
In this cross-sectional study, IOP was measured in 94 eyes of 94 healthy subjects with the Goldmann, manual applanation resonance, Icare, Topcon non-contact, Ocular Response Analyzer and Corvis’s tonometers. Comparison of the IOPs measured with different techniques was done using the repeated measures analysis of variance while the central corneal thickness as a covariate.  The Bland-Altman plots and intraclass correlation coefficients were used to assess the agreement between the measurements. Limits of agreement were determined as the mean difference ±1.96 SD. Regression analysis was used to estimate the effect of central corneal thickness, corneal hysteresis, and corneal resistance factor on IOPs obtained using different tonometers.
Results:
The lowest mean IOP was obtained with the Goldmann tonometer (13.1 ± 2.6 mmHg) and the highest with the Topcon non-contact tonometer (17.3 ± 2.5 mm Hg). There was a statistically significant difference between the pressure measured by Goldmann's tonometer and other tonometers. The mean IOP measured using Icare (14.6 ± 3.4 mmHg) demonstrated the smallest mean difference and the highest agreement with the Goldmannn tonometer results. Central corneal thickness significantly affected all IOPs except the cornea-compensated IOP (IOPcc). The highest influence of IOP on the corneal resistance factor was related to Topcon non-contact tonometer and Goldmann correlated IOP (IOPg), while the lowest was seen with IOPcc and Goldmann.
Conclusions:
The Icare tonometer had the highest agreement among the different tonometers with the Goldmann tonometer. The central thickness of the cornea affects the results of all tonometers except IOPcc. Among the two evaluated corneal biomechanical parameters, the corneal resistance factor was the only biomechanical parameter effective on IOPs measured with all devices.

Keywords

References

  1. Suman S, Agrawal A, Pal VK, Pratap VB. Rebound tonometer: ideal tonometer for measurement of accurate intraocular pressure. J Glaucoma 2014; 23(9): 633-637.
  2. Bao F, Deng M, Wang Q, Huang J, et al. Evaluation of the relationship of corneal biomechanical metrics with physical intraocular pressure and central corneal thickness in ex vivo rabbit eye globes. Exp Eye Res 2015; 137: 11-17.
  3. Martinez-de-la-Casa JM, Garcia-Feijoo J, Fernandez-Vidal A, Mendez-Hernandez C, et al. Ocular response analyzer versus Goldmann applanation tonometry for intraocular pressure measurements. Invest Ophthalmol Vis Sci 2006; 47(10): 4410-4414.
  4. Bayoumi NH, Bessa AS, El Massry AA. Ocular response analyzer and goldmann applanation tonometry: a comparative study of findings. J Glaucoma 2010; 19(9): 627-631.
  5. Hong J, Xu J, Wei A, Deng SX, et al. A new tonometer--the Corvis ST tonometer: clinical comparison with noncontact and Goldmann applanation tonometers. Invest Ophthalmol Vis Sci 2013; 54(1): 659-665.
  6. Eklund A, Hallberg P, Lindén C, Lindahl OA. An applanation resonator sensor for measuring intraocular pressure using combined continuous force and area measurement. Invest Ophthalmol Vis Sci 2003; 44(7): 3017-3024.
  7. Chui WS, Lam A, Chen D, Chiu R. The influence of corneal properties on rebound tonometry. Ophthalmology 2008; 115(1): 80-84.
  8. Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, Garcia-Sanchez J. Reproducibility and clinical evaluation of rebound tonometry. Invest Ophthalmol Vis Sci 2005; 46(12): 4578-4580.
  9. Yao WJ, Crossan AS. An update on postrefractive surgery intraocular pressure determination. Curr Opin Ophthalmol 2014; 25(4): 258-263.
  10. Harada Y, Hirose N, Kubota T, Tawara A. The influence of central corneal thickness and corneal curvature radius on the intraocular pressure as measured by different tonometers: noncontact and goldmann applanation tonometers. J Glaucoma 2008; 17(8): 619-625.
  11. Murase H, Sawada A, Mochizuki K, Yamamoto T. Effects of corneal thickness on intraocular pressure measured with three different tonometers. Jpn J Ophthalmol 2009; 53(1): 1-6.
  12. Doughty MJ, Zaman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. Surv Ophthalmol 2000; 44(5): 367-408.
  13. Whitacre MM, Stein R. Sources of error with use of Goldmann-type tonometers. Surv Ophthalmol. 1993; 38(1): 1-30.
  14. Morales-Fernandez L, Martinez-de-la-Casa JM, Garcia-Feijoo J, Saenz-Frances F, et al. Reproducibility of the new Goldmann AT900D digital tonometer. J Glaucoma 2012; 21(3): 186-188.
  15. Salvetat ML, Zeppieri M, Tosoni C, Brusini P. Repeatability and accuracy of applanation resonance tonometry in healthy subjects and patients with glaucoma. Acta Ophthalmol 2014; 92(1): e66-73.
  16. Ogbuehi KC, Mucke S, Osuagwu UL. Influence of central corneal thickness on measured intraocular pressure differentials: Nidek RKT-7700, Topcon CT-80 NCTs and Goldmann Tonometer. Ophthalmic Physiol Opt 2012; 32(6): 547-555.
  17. Sullivan-Mee M, Gerhardt G, Halverson KD, Qualls C. Repeatability and reproducibility for intraocular pressure measurement by dynamic contour, ocular response analyzer, and goldmann applanation tonometry. J Glaucoma 2009; 18(9): 666-673.
  18. Reznicek L, Muth D, Kampik A, Neubauer AS, et al. Evaluation of a novel Scheimpflug-based non-contact tonometer in healthy subjects and patients with ocular hypertension and glaucoma. Br J Ophthalmol 2013; 97(11): 1410-1414.
  19. Luce DA. Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg. 2005;31(1):156-162.
  20. Bang SP, Lee CE, Kim YC. Comparison of intraocular pressure as measured by three different non-contact tonometers and goldmann applanation tonometer for non-glaucomatous subjects. BMC Ophthalmol 2017; 17(1): 199.
  21. Grippo TM, Liu JH, Zebardast N, Arnold TB, et al. Twenty-four-hour pattern of intraocular pressure in untreated patients with ocular hypertension. Invest Ophthalmol Vis Sci 2013; 54(1): 512-517.
  22. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1(8476): 307-310.
  23. WM PL. Foundations of Clinical Research. Applications to Practice. . 2 ed. Upper Saddle River, NJ: Prentice Hall Health2000.
  24. Galgauskas S, Strupaite R, Strelkauskaite E, Asoklis R. Comparison of intraocular pressure measurements with different contact tonometers in young healthy persons. Int J Ophthalmol 2016; 9(1): 76-80.
  25. Jóhannesson G, Hallberg P, Eklund A, Lindén C. Introduction and clinical evaluation of servo-controlled applanation resonance tonometry. Acta Ophthalmol 2012; 90(7): 677-682.
  26. Smedowski A, Weglarz B, Tarnawska D, Kaarniranta K, et al. Comparison of three intraocular pressure measurement methods including biomechanical properties of the cornea. Invest Ophthalmol Vis Sci 2014; 55(2): 666-673.
  27. Ogbuehi KC, Almubrad TM. Evaluation of the intraocular pressure measured with the ocular response analyzer. Curr Eye Res 2010; 35(7): 587-596.
  28. Kouchaki B, Hashemi H, Yekta A, Khabazkhoob M. Comparison of current tonometry techniques in measurement of intraocular pressure. J Curr Ophthalmol 2017; 29(2): 92-97.
  29. van der Jagt LH, Jansonius NM. Three portable tonometers, the TGDc-01, the ICARE and the Tonopen XL, compared with each other and with Goldmann applanation tonometry*. Ophthalmic Physiol Opt 2005; 25(5): 429-435.
  30. Dahlmann-Noor AH, Puertas R, Tabasa-Lim S, El-Karmouty A, et al. Comparison of handheld rebound tonometry with Goldmann applanation tonometry in children with glaucoma: a cohort study. BMJ Open  2013; 3(4): e001788.
  31. Fern KD, Manny RE, Gwiazda J, Hyman L, et al. Intraocular pressure and central corneal thickness in the COMET cohort. Optom Vis Sci 2012; 89(8): 1225-1234.
  32. Gupta V, Sony P, Agarwal HC, Sihota R, et al. Inter-instrument agreement and influence of central corneal thickness on measurements with Goldmann, pneumotonometer and noncontact tonometer in glaucomatous eyes. Indian J Ophthalmol 2006; 54(4): 261-265.
Journal of Paramedical Sciences & Rehabilitation
Volume 11, Issue 3
December 2022
Pages 7-18

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