Repeatability of intraocular pressure measurements with Icare PRO rebound, Tono-Pen AVIA, and Goldmann tonometers in sitting and reclining positions

Abstract

BackgroundIcare PRO (ICP) is a new Rebound tonometer that is able to measure intraocular pressure (IOP) in both sitting and reclining positions. In this study, the gold standard Goldmann tonometer (GAT) was compared to ICP and Tono-Pen AVIA (TPA). Hypothesis was that repeatability of GAT is superior to ICP and TPA.Methods36 eyes of 36 healthy caucasian individuals, 13 male and 26 females, 17 right and 19 left eyes have been included in this prospective, randomized, cross-sectional study. The study was conducted at a single site (Dept. of Ophthalmology, UniversityHospital Zurich, Switzerland). Primary outcome measures were Intraclass correlation coefficients (ICC) and coefficients of variation (COV) and test-retest repeatability as visualized by Bland-Altman analysis. Secondary outcome measures were IOP in sitting (GAT, ICP and TPA) and in reclining (ICP and TPA) position.ResultsMean IOP measured by GAT was 14.9±3.5 mmHg. Mean IOP measured by ICP was 15.6±3.1 mmHg (with TPA 14.8±2.7 mmHg) in sitting and 16.5±3.5 mmHg (with TPA 17.0±3.0 mmHg) in reclining positions. COVs ranged from 2.9% (GAT) to 6.9% (ICP reclining) and ICCs from 0.819 (ICP reclining) to 0.972 (GAT).ConclusionsRepeatability is good with all three devices. GAT has higher repeatability compared to the two tested hand-held devices with lowest COVs and highest ICCs. IOP was higher in the reclining compared to the sitting position.Trial registrationThe study was registered to the Clinical Trials Register of the US National Institute of Health, NCT01325324.

Evaluation of intraocular pressure estimates obtained using an iCare rebound tonometer

“…The Bland and Altman plots of the limits of agreement of within 3.0 mmHg showed comparable intra‐observer repeatability to the study by Schweier and colleagues, which had +2.8 to −3.3 limits of agreement. Although the readings obtained by the first investigator in two different attempts were in very good agreement and not statistically different, the IOP estimates by the second investigator on the first and second attempts were significantly different.…”

Intraocular Pressure in Children: The Effect of Body Position as Assessed by Icare and Tono-Pen Tonometers

“…13,15,16 These studies have all been performed in adults and have demonstrated that the Icare PRO, similar to the Icare, correlates well with both GAT and Tono-Pen and that it reads generally higher than GAT. Jablonski et al 13 recently reported that the Icare PRO correlates well with GAT and Perkins tonometry, as they compared the tonometers and also measured the effect of body position on IOP.…”

Immediate Postoperative Intraocular Pressure Changes After Anterior Chamber Air Fill in Descemet Membrane Endothelial Keratoplasty

“…23,24 Of note, a higher volume of air fill tends to minimize the difference between both positions. Thus, the position of IOP measurement and the amount of anterior chamber air should be interpreted cautiously, especially in pressure-sensitive patients.…”