Objective: to compare intraocular pressure (IOP) measurements from two different instruments, the rebound tonometer (Icare ) and the Tono-Pen XL (TP), with that from Goldmann applanation tonometer (GAT) and to determine the influence of central corneal thickness on these three instruments. Methods: 274 eyes from 137 healthy volunteers were evaluated in this cross-sectional study. All IOP measurements were made by the same examiner who was blinded to the observed result. Icare tonometry was performed first, followed by TP, GAT, and pachymetry in a random order. Results: a good correlation was observed between IOP measurements obtained with Icare and GAT (r = 0.79, p = 0.000) and between TP and GAT (r = 0.69, p = 0.000). Icare and TP measurements were consistently higher than GAT measurements. A Bland-Altman plot indicated that the 95% limits of agreement between Icare and GAT were 0.98 ± 3.12 (mean ± SD; range, −5.14 to 7.11) mmHg, and those between TP and GAT were 1. 88 ± 3.20 (range, −4.38 to 8.15) mmHg. In the group of patients with thinner corneas, Icare overestimated IOP by 0.5mmHg compared with IOP obtained using GAT and by 1.8 mmHg compared with IOP obtained using TP. In the group of patients with thicker corneas, Icare overestimated IOP by 1.4 mmHg compared IOP obtained using GAT and by 1.5 mmHg compared with IOP obtained using TP. Conclusion: IOP measurements obtained with Icare and TP showed a good correlation with that of GAT. Both tonometers tend to overestimate IOP compared to GAT. In patients with thinner corneas, Icare perfrmed better than TP.
Comparar las mediciones de la presión intraocular (PIO) de dos instrumentos diferentes, el tonómetro de rebote (Icare ® ) y el Tono-Pen ® XL (TP), con el tonómetro de aplanación de Goldmann (TAG), y determinar la influencia del grosor corneal central en estos tres instrumentos. Métodos: En este estudio transversal se evaluaron 274 ojos de 137 voluntarios sanos. Todas las mediciones de la PIO fueron hechas por el mismo examinador que estaba cegado al resultado observado. La tonometría Icare ® se realizó primero, seguida de TP, TAG y paquimetría en orden aleatorio. Resultados: Se observó una buena correlación entre las mediciones de PIO obtenidas con Icare ® y TAG (r = 0.79; p = 0.000) y entre TP y TAG (r = 0.69; p = 0.000). Las mediciones de Icare ® y TP fueron consistentemente más altas que las mediciones del TAG. Un diagrama de Bland-Altman indicó que los límites del 95% de concordancia entre Icare ® y TAG fueron de 0.98 ± 3.12 (media ± DE, rango, −5.14 a 7.11) mmHg, y entre TP y TAG fueron de 1.88 ± 3.20 (rango, −4.38 a 8.15) mmHg. En el grupo de pacientes con córneas más delgadas, Icare ® sobreestimó la PIO en 0.5 mmHg en comparación con la PIO obtenida utilizando TAG y en 1.8 mmHg en comparación con la PIO obtenida utilizando TP. En el grupo de pacientes con córneas más gruesas, Icare ® sobreestimó la PIO en 1.4 mmHg en comparación con la PIO obtenida utilizando TAG y en 1.5 mmHg en comparación con la PIO obtenida utilizando TP. Conclusión: Las mediciones de la PIO con Icare ® y TP mostraron una buena correlación con las del TAG. Ambos tonómetros tendieron a sobreestimar la PIO en comparación con TAG. En pacientes con córneas más delgadas, Icare ® fue mejor que TP.
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