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Duran M. Comparison of intraocular pressure measurements obtained by icare pro tonometer, non-contact tonometer and Goldmann applanation tonometer in healthy individuals. J Fr Ophtalmol 2023; 46:1195-1203. [PMID: 37666735 DOI: 10.1016/j.jfo.2023.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE The goal of this paper was to compare the intraocular pressure (IOP) measurements obtained via iCare Pro rebound (IRT), non-contact tonometry (NCT), and Goldmann applanation (GAT) tonometry in healthy subjects. MATERIALS AND METHODS One hundred and twenty-five healthy individuals were included in this study. The participants' IOP measurements were obtained via non-contact tonometry. After routine ophthalmic examination, central corneal thickness (CCT) was measured with a topography device. Intraocular pressure was measured via iCare Pro rebound tonometry. After waiting for 5minutes, three measurements were taken with GAT under topical anaesthesia, and their means were recorded. Interdevice agreement was evaluated with the intraclass correlation coefficient (ICC) and Bland-Altman analysis. RESULTS The mean IOP measurements for NCT, IRT, and GAT were 15.97±2.99, 17.47±2.86, and 16.46±2.68mmHg, respectively. The mean difference between NCT and GAT was -0.49± 1.89mmHg, the mean difference between IRT and GAT was 1.01±1.90mmHg, and the mean difference between NCT and IRT was -1.50±2.02mmHg. Agreement between devices was found to be >0.8 for each tonometry ICC. There were significant positive correlations between the measurements obtained via these three instruments and CCT. CONCLUSION In this study, IOP was measured slightly lower with NCT than GAT, but it was about 1mmHg higher with IRT than GAT on average. All three devices appeared to be affected by CCT, with NCT being the most affected in this regard. The three instruments can be used for routine inspection and screening. However, considering the differences in the measurements obtained by using them, it is clear that following up IOP measurements with GAT measurements is beneficial in advanced glaucoma patients.
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Affiliation(s)
- M Duran
- Department of Ophthalmology, Erol Olcok Training and Research Hospital, Hitit University, Inönü avenue, N(o) 176, 19040, Çorum, Turkey.
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2
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Glaucoma management in patients with penetrating keratoplasty or keratoprosthesis. Curr Opin Ophthalmol 2023; 34:95-102. [PMID: 36730770 DOI: 10.1097/icu.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW Advances in surgical techniques and postoperative care have significantly improved rates of short-term complications following keratoplasty; however, glaucoma remains a highly prevalent long-term and potentially devastating complication for postkeratoplasty patients. In this review, we provide an overview of recent literature on glaucoma management in patients who have undergone penetrating keratoplasty or the Boston keratoprosthesis type I (KPro) implantation. RECENT FINDINGS New research suggests an inflammatory cause underlying glaucoma following KPro. Accurate IOP measurement is difficult in patients postkeratoplasty; study of objective techniques such as PDCT or Tono-Pen in penetrating keratoplasty eyes and trans-palpebral Diaton tonometry in KPro eyes have shown promising results. Early glaucoma surgical intervention should be considered for patients undergoing penetrating keratoplasty and KPro. SUMMARY Patients who have undergone penetrating keratoplasty or implantation of the Boston keratoprosthesis type I should be monitored frequently for elevated intraocular pressure and for other signs of glaucomatous optic nerve damage. Intraocular pressure elevation should be treated promptly either medically or surgically while minimizing risk to the corneal graft. Further research into inflammatory causes and other treatment modalities is promising for the long-term visual success in these patients.
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Schornack MM, Vincent SJ, Walker MK. Anatomical and physiological considerations in scleral lens wear: Intraocular pressure. Cont Lens Anterior Eye 2023; 46:101535. [PMID: 34824016 DOI: 10.1016/j.clae.2021.101535] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 02/06/2023]
Abstract
Intraocular pressure (IOP) is maintained through complex and interrelated systems which control aqueous production and drainage, and it has been suggested that scleral lens (SL) wear may disrupt these vital homeostatic processes. This review provides an overview of anatomical and physiological processes that control IOP, identifies potential effects of SLs on these regulatory mechanisms, and examines studies that have attempted to quantify the effect of SLs on IOP. Lack of access to the cornea during SL wear makes accurate assessment of IOP challenging; therefore, a range of different assessment techniques and instruments have been employed to quantify IOP during and following SL wear. Some studies have evaluated IOP using standard techniques prior to lens application and following lens removal, or through a large central fenestration. Other studies have utilised instruments that facilitate assessment of IOP on the peripheral cornea or conjunctiva overlying the sclera (e.g. Schiotz, transpalpebral, and pneumatonometry). Two studies have recently evaluated changes in optic nerve structure during SL wear. Conflicting results have been reported on this topic, much of which examines changes in IOP in healthy subjects over limited periods of time. Currently, only a few studies have reported on long-term effects of SL wear on IOP in habitual SL wearers (after lens removal). Future research in this area must not only consider the fact that ocular conditions treated with SLs may potentially alter corneal biomechanical properties which can influence IOP, but also that these properties may be further altered by SL wear. Monitoring other risk factors for glaucoma (permanent alterations in optic nerve physiology, visual field defects) could provide a more comprehensive assessment of potentially increased risk of glaucomatous optic neuropathy due to SL wear. Ongoing clinical assessment of optic nerve structure and function is advisable in patients at risk for glaucoma who require SLs.
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Affiliation(s)
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Queensland, Australia.
| | - Maria K Walker
- University of Houston College of Optometry, The Ocular Surface Institute, Houston, TX, USA.
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O’Connell A, Stephenson KAJ, Flitcroft I. Risk of Neurotoxicity with Multiple General Anaesthetics for Examination Under Anaesthesia in Paediatric Ophthalmology - A Cause for Concern? Clin Ophthalmol 2023; 17:291-302. [PMID: 36711257 PMCID: PMC9880563 DOI: 10.2147/opth.s387098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose To evaluate the impact of clinical protocol change via active minimisation on the number of general anaesthetic (GA)/sedation episodes for diagnostic ophthalmic purposes at Children's Health Ireland at Temple Street (CHI-TS), Dublin, Ireland, from 2016 to 2019, inclusive. Change was implemented following published cautionary principles in 2016 by the FDA regarding the potential neurotoxic risk from multiple GA exposure in children. Methods Retrospective analysis of electronic operating theatre records was completed using procedure codes "Ophthalmological examination" and "Examination of fundi". Available records for patients undergoing multiple examination under anaesthesia (EUA) procedures were assessed for demographics, indication. Comparison was made regarding overall EUA numbers and breakdown for each year, before and after the new departmental approach. From 2018 onward, a patient-centred, departmental strategy of active minimisation of EUA was adopted, using strategies of "training, technology and patience". A literature review was conducted using online databases. Results A total of 450 EUAs were performed over the 4 years investigated. In the former 2 years of the study period, prior to departmental policy change, EUAs represented 32% (304 of 948 total theatre episodes) of the ophthalmic theatre caseload. In the latter 2 years of this study period, this proportion fell to 19% (146 EUAs of 783 theatre episodes). Total theatre case numbers were comparable in both time periods. Eighteen children had multiple EUAs (ie, ≥2 EUAs, mean 6.5, SD 2.9) for life/sight threatening indications, totalling 116 EUAs (25.7%). Conclusion A significant reduction in diagnostic EUA volume was accomplished resulting in reduced individual patient risk and increased capacity for surgical interventions. A detailed description of this methodology is included for the purposes of replication at comparable units. EUA will continue to play a crucial role in the management of life/sight threatening conditions but the application of a cautionary principle to reduce EUA, where possible, is appropriate to reduce potential for neurotoxicity.
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Affiliation(s)
- Ann O’Connell
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland,Correspondence: Ann O’Connell, Children’s Health Ireland at Temple Street, Dublin, Ireland, Tel +353 1 8784200, Email
| | - Kirk A J Stephenson
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Ian Flitcroft
- Ophthalmology Department, Children’s Health Ireland at Temple Street Hospital, Dublin, Ireland
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Wireless theranostic smart contact lens for monitoring and control of intraocular pressure in glaucoma. Nat Commun 2022; 13:6801. [PMID: 36357417 PMCID: PMC9649789 DOI: 10.1038/s41467-022-34597-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
Glaucoma is one of the irreversible ocular diseases that can cause vision loss in some serious cases. Although Triggerfish has been commercialized for monitoring intraocular pressure in glaucoma, there is no smart contact lens to monitor intraocular pressure and take appropriate drug treatment in response to the intraocular pressure levels. Here, we report a precisely integrated theranostic smart contact lens with a sensitive gold hollow nanowire based intraocular pressure sensor, a flexible drug delivery system, wireless power and communication systems and an application specific integrated circuit chip for both monitoring and control of intraocular pressure in glaucoma. The gold hollow nanowire based intraocular pressure sensor shows high ocular strain sensitivity, chemical stability and biocompatibility. Furthermore, the flexible drug delivery system can be used for on-demand delivery of timolol for intraocular pressure control. Taken together, the intraocular pressure levels can be successfully monitored and controlled by the theranostic smart contact lens in glaucoma induced rabbits. This theranostic smart contact lens would be harnessed as a futuristic personal healthcare platform for glaucoma and other ocular diseases.
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Das MR, Krishnadas R. Commentary: Glaucoma following penetrating keratoplasty: A double whammy. Indian J Ophthalmol 2022; 70:1246-1247. [PMID: 35326025 PMCID: PMC9240542 DOI: 10.4103/ijo.ijo_93_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Mano Ranjan Das
- Cornea and Refractive Surgery Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Ramaswami Krishnadas
- Glaucoma Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
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Gumus G, Altan C, Yildirim Y, Beşek NK, Genç S, Kirgiz A, Durusoy GK, Ağca A. Early intraocular pressure changes following different keratoplasty techniques and association with cornea parameters and anterior chamber depth. Ther Adv Ophthalmol 2022; 14:25158414221083359. [PMID: 35321307 PMCID: PMC8935592 DOI: 10.1177/25158414221083359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Corneal transplantation surgery is associated with an increased risk of intraocular pressure (IOP) elevation. Increased IOP may cause irreversible vision loss and graft failure. Objective: We aimed to evaluate early IOP changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD), and IOP changes. Methods: We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), and Descemet membrane endothelial keratoplasty (DMEK) in this observational study. ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results: In total, 22 patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and postoperatively hour 6, and between the IOP preoperatively and postoperatively hour 24 was statistically significant in the three types of surgery ( p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group ( p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups ( p = 0.021). There was no correlation between ACD, CT, K values, and IOP in any group. Conclusion: IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.
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Affiliation(s)
- Gulsah Gumus
- Gaziantep Ersin Aslan Training and Research Hospital, Eyüpoğlu Mahallesi, Hürriyet Cd. No:40, Şahinbey, 27010 Gaziantep, Turkey
| | - Cigdem Altan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yusuf Yildirim
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nilay Kandemir Beşek
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Selim Genç
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Kirgiz
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Alper Ağca
- Dünyagöz Ataköy Hospital, Istanbul, Turkey
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8
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Intraocular Pressure Measurement after Penetrating Keratoplasty. Diagnostics (Basel) 2022; 12:diagnostics12020234. [PMID: 35204325 PMCID: PMC8870783 DOI: 10.3390/diagnostics12020234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/17/2022] Open
Abstract
Assessing the intraocular pressure is a difficult but crucial task in the follow-up of patients that have undergone penetrating keratoplasty. Early recognition of elevated intraocular pressure and/or glaucoma and establishment of the appropriate treatment is essential to ensure the best possible visual outcome for patients dealing with this feared complication. Although Goldmann applanation tonometry is still the gold standard for measuring the intraocular pressure, its limitations in postkeratoplasty eyes, due to postoperative modified corneal morphology, have led to the search for more suitable alternatives. This review is the result of a comprehensive literature search in the MEDLINE database that aims to present glaucoma in the context of perforating keratoplasty, the corneal properties with impact on ocular pressure measurement, and the results achieved with the most important tonometers that have been studied in this pathology. Goldmann applanation tonometry remains the reference for intraocular pressure assessment even in corneas after penetrating keratoplasty. However, some promising alternatives have emerged, the most important of which are the Pascal dynamic contour tonometry, the Tono-Pen XL, the ocular response analyzer, and the iCare. All have advantages and disadvantages but have proved to be appropriate alternatives, especially in cases in which Goldmann applanation tonometry cannot be used.
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Ashano O, Oderinlo O, Ogunro A, Ashano E. A comparison of goldmann applanation tonometry and rebound tonometry measurements among patients attending a glaucoma clinic in Southwest Nigeria. Niger J Clin Pract 2022; 25:1542-1547. [DOI: 10.4103/njcp.njcp_95_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Brusini P, Salvetat ML, Zeppieri M. How to Measure Intraocular Pressure: An Updated Review of Various Tonometers. J Clin Med 2021; 10:3860. [PMID: 34501306 PMCID: PMC8456330 DOI: 10.3390/jcm10173860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.
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Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology, Policlinico “Città di Udine”, 33100 Udine, Italy;
| | - Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Anders LM, Gatzioufas Z, Grieshaber MC. Challenges in the complex management of post-keratoplasty glaucoma. Ther Adv Ophthalmol 2021; 13:25158414211031397. [PMID: 34350382 PMCID: PMC8295943 DOI: 10.1177/25158414211031397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Glaucoma is a serious complication after corneal transplantation and itself a common cause for graft failure and leading cause of vision loss post-keratoplasty due to corneal endothelial decompensation. Endothelial keratoplasty procedures like Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) may be superior to penetrating keratoplasty (PK) regarding the incidence of elevated intraocular pressure (IOP) and development of glaucoma. There are indications that regardless of the method of keratoplasty, some corneal diseases like pseudophakic bullous keratopathy, corneal perforation, and graft rejection have a higher risk for developing post-keratoplasty glaucoma than keratoconus and corneal dystrophies and likewise respond less to IOP lowering therapy. In this review, the pathophysiology of post-keratoplasty glaucoma, the diagnostic tools with focus on different devices, and their limitations with regard to measuring IOP and the treatment modalities are presented.
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Affiliation(s)
- Lisa-Marie Anders
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Zisis Gatzioufas
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
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12
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Kim TY, Shin S, Choi H, Jeong SH, Myung D, Hahn SK. Smart Contact Lenses with a Transparent Silver Nanowire Strain Sensor for Continuous Intraocular Pressure Monitoring. ACS APPLIED BIO MATERIALS 2021; 4:4532-4541. [PMID: 35006789 PMCID: PMC10867858 DOI: 10.1021/acsabm.1c00267] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Continuous intraocular pressure (IOP) monitoring can provide a paradigm shift in the management of patients with glaucoma as a facile alternative to conventional diagnostic methods. However, the low sensitivity and functional instability of current IOP sensors have limited their clinical utility in the management of glaucoma. Here, we have developed a smart contact lens integrated with a transparent silver nanowire IOP strain sensor and wireless circuits for noninvasive, continuous IOP monitoring. After confirming the robust stability of the IOP sensor within the smart contact lens in the presence of tears and repeated eyelid blink model cycles, we were able to monitor IOP changes on polydimethylsiloxane model eyes in vitro. In vivo tests demonstrated that our fully integrated wireless smart contact lens could successfully monitor the change in IOP in living rabbit eyes, which was clearly validated by the conventional invasive tonometer IOP test. Taken together, we could confirm the feasibility of our smart contact lens as a noninvasive platform for continuous IOP monitoring of glaucoma patients.
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Affiliation(s)
- Tae Yeon Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sangbaie Shin
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
| | - Hyunsik Choi
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - Sang Hoon Jeong
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
| | - David Myung
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk 37673, Korea
- PHI BIOMED Co., 168 Yeoksam-ro, Gangnam-gu, Seoul 06248, South Korea
- Department of Ophthalmology and Chemical Engineering, Stanford University, 443 Via Ortega, Stanford, California 94305, United States
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Lee JU, Park KS, Kim J, Lee SB, Lee YH, Kim KN. Usefulness of the Icare ic200 Rebound Tonometer in Korean. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.5.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yeh SJ, Chen KH, Kuang TM, Liu CJL, Chen MJ. Comparison of the iCare, Tono-Pen, non-contact airpuff, and Goldmann applanation tonometers in eyes with corneal edema after penetrating keratoplasty. J Chin Med Assoc 2021; 84:320-325. [PMID: 33587519 DOI: 10.1097/jcma.0000000000000476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To compare the utility of the iCare, Tono-Pen, and non-contact airpuff (NCT) tonometers with the Goldmann applanation tonometer (GAT) for measuring intraocular pressure (IOP) in patients with corneal edema after penetrating keratoplasty (PKP) and to assess the effects of central corneal thickness (CCT) and corneal curvature (CC) on IOP measurements. METHODS Thirty-two eyes of 27 patients with corneal edema after PKP due to corneal abnormalities and 43 control eyes of 30 patients with normal corneas were recruited. Before IOP measurements, all patients underwent a baseline examination, including auto-refraction, keratometry, slit lamp biomicroscopy, and CCT measurement. IOP was measured using the devices in the same order: first the NCT, followed by the iCare, Tono-Pen, and GAT. The differences between the iCare, Tono-Pen, NCT, and GAT were calculated with repeated-measures analysis of variance. The Bland-Altman method was used to assess the agreement between the iCare, Tono-Pen, and NCT versus the GAT. The influences of CCT and CC on IOP measurement were evaluated by correlation analysis using Pearson's correlation coefficient. RESULTS Mean IOP measurements were significantly higher with the NCT and Tono-Pen than with the GAT in the PKP and control groups. When compared with GAT, iCare showed significantly higher IOP readings in the control group, but the IOP readings did not differ between the iCare and GAT in the PKP group. Poor agreement was noted between the NCT and GAT in both groups. The Tono-Pen showed clinically acceptable agreement with GAT in control eyes and poor agreement in PKP eyes. The agreement between the iCare and GAT appeared to be clinically acceptable in both groups. Correlation analysis of the results from control eyes showed that the IOP measurements with the GAT and NCT were weakly related to CCT and moderately correlated with CC. The iCare IOP readings were weakly correlated with CCT and CC. CONCLUSION In the PKP group, the NCT and Tono-Pen significantly overestimated IOP, whereas the iCare IOP readings were similar to those obtained using the GAT. Poor agreement was noted between the NCT and GAT as well as between the Tono-Pen and GAT, but the iCare showed clinically acceptable agreement with GAT. In normal corneas, the GAT, NCT, and iCare were affected by CCT and CC. The iCare tonometer was less affected by corneal edema than were the NCT and the Tono-Pen. The iCare appears to be a useful device for IOP measurement in eyes with corneal edema after PKP.
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Affiliation(s)
- Shih-Jung Yeh
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ko-Hua Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Meidicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tung-Mei Kuang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Meidicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Meidicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Mei-Ju Chen
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Meidicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Borroni D, Gadhvi KA, Hristova R, McLean K, Rocha de Lossada C, Romano V, Kaye S. Influence of Corneal Visualization Scheimpflug Technology Tonometry on Intraocular Pressure. OPHTHALMOLOGY SCIENCE 2021; 1:100003. [PMID: 36246003 PMCID: PMC9562332 DOI: 10.1016/j.xops.2021.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/28/2020] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To investigate the effect of Corneal Visualization Scheimpflug Technology tonometry (CST) on intraocular pressure (IOP). Design Cohort study. Participants Patients with and without primary open-angle glaucoma (POAG) were included. Methods Intraocular pressure was measured using the Icare rebound tonometer (ICRT; Icare Finland Oy) and the biomechanically corrected IOP (bIOP) using the CST. Intraocular pressure was measured at baseline with ICRT, followed by a CST measurement in one eye with the fellow eye acting as a control. Icare measurements were repeated at 10 seconds and 1, 2, 4, 8, 15, 30, and 60 minutes in both eyes. The ratio of test eye IOP to fellow eye IOP was used to control for intrasubject variation. Main Outcome Measures Intraocular pressure change following Corneal Visualization Scheimflug Technology tonometry. Results Forty participants (mean age, 54.09 ± 20.08 years) were included comprising 20 patients with POAG and 20 patients with no ocular abnormalities other than cataract. Mean central corneal thickness was similar in those without POAG (547.4 ± 55.05 μm) and with POAG (520.22 ± 37.59 μm; P = 0.14). No significant change was found in IOP measured with the ICRT in the fellow eye versus the 1-hour period in either the healthy (P = 0.87) or POAG (P = 0.92) group. Significant changes were found in IOP after CST measurement for both healthy (P < 0.01) and glaucomatous (P < 0.01) eyes. After the CST measurement, the IOP reduced continuously from a mean of 13.75 mmHg to 10.84 mmHg at 4 minutes for healthy eyes and from 13.28 mmHg to 11.11 mmHg at 8 minutes for glaucomatous eyes before approaching (83% for healthy eyes and 92% POAG eyes) the pre-CST measurement at 1 hour. Conclusions Corneal Visualization Scheimpflug Technology tonometry causes a significant reduction in IOP in both glaucomatous and healthy eyes that lasts for at least 1 hour afterward.
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Abstract
Supplemental Digital Content is Available in the Text. To identify risk factors for the development of ocular hypertension after keratoplasty.
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Alio JL, Montesel A, El Sayyad F, Barraquer RI, Arnalich-Montiel F, Alio Del Barrio JL. Corneal graft failure: an update. Br J Ophthalmol 2020; 105:1049-1058. [DOI: 10.1136/bjophthalmol-2020-316705] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 11/04/2022]
Abstract
Corneal graft surgery is one of the most successful forms of human solid-tissue transplantation, and nowadays, there is a worldwide expansion of the surgical volume of corneal grafts. This surgery is continuously evolving, with new surgical techniques and postoperative treatments that have considerably increased the chance of survival for the grafts. Despite the high rate of success, corneal transplantation is still complicated by a relevant risk of graft failure. This study investigates the causes that lead to the failure of the different corneal graft surgical techniques and provides an updated synthesis on this topic. A comprehensive review of the main pathological pathways that determine the failure of corneal grafts is provided, analysing the main risk factors and disclosing the survival rates of the principal form of corneal grafts. Our results revealed that penetrating keratoplasty has higher failure rates than lamellar keratoplasty, with immunological rejection being the leading cause of graft failure, followed by late endothelial failure (LEF) and ocular surface disorders. Postoperative glaucoma and dehiscence of the surgical wound represent other important causes of failure. Endothelial keratoplasty showed the lowest rates of failure in the mid-term, with LEF, detachment of the graft and primary graft failure representing the most common pathological reasons for failure.
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Perez-Garcia P, Morales-Fernandez L, Saenz-Frances F, Mendez-Hernandez CD, Garcia-Feijoo J, Santos-Bueso E, Martinez-de-la-Casa JM. Comparision of intraocular pressure measured using the new icare 200™ rebound tonometer and the Perkins™ applanation tonometer in healthy subjects and in patients with primary congenital glaucoma. ACTA ACUST UNITED AC 2020; 96:175-180. [PMID: 32690372 DOI: 10.1016/j.oftal.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/27/2020] [Accepted: 06/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare intraocular pressure (IOP) measurements obtained using the Icare 200™ (IC200) rebound tonometer and the hand-held version of the Goldmann Applanation Tonometer (Perkins™ tonometer, GAT) in patients with primary congenital glaucoma (PCG) and in healthy subjects. MATERIAL AND METHODS A total of 42 eyes of healthy subjects (G1) and 40 patients with PCG (G2) were analysed. The following clinical data were collected: gender, age, Cup/Disc ratio, central corneal thickness (CCT). IOP was determined in the examination room using the IC200 and GAT tonometers, in the same order. Agreement between both tonometers was determined using the intraclass correlation coefficient (ICC) and Bland-Altman plot. A linear regression analysis was used to establish the IOP was affected by the studied variables. RESULTS Mean IOP between both tonometers (IC200 minus GAT) was: G1=15.91 (2.57) mmHg vs. 15.06 (2.12) mmHg (mean difference, MD=0.84 (0.50) mmHg; P<.101) and G2=20.10 (6.37) vs.19.12 (5.62) (MD=0.98 (1.36); P=.474). Excellent agreement was found between IC200 and GAT in both groups (ICC=G1: 0.875 (95% CI; 0.768-0.933; P<.001); G2: 0.924 (95% CI; 0.852-0.961; P<.001), and there was a statistically significant correlation between the IOP difference measured with IC200 and GAT and CCT in G1 (B=0.021; 95% CI; 0.005-0.037; P=.008), but was not statistically significant in G2. CONCLUSION There was excellent agreement between the IC200 and GAT tonometers, both in healthy subjects and PCG, with a trend to overestimate IOP when measured with IC200. There was no influence by CCT on IOP measurements in patients with PGC.
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Maeng B, Chang HK, Park J. Photonic crystal-based smart contact lens for continuous intraocular pressure monitoring. LAB ON A CHIP 2020; 20:1740-1750. [PMID: 32347844 DOI: 10.1039/c9lc01268k] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Glaucoma is a very common disease after cataracts and is dangerous enough to cause irreversible blindness. However, often the main symptom of glaucoma is difficult to recognize because it may be absent or appear late, so the risk of blindness is greater. Intraocular pressure (IOP) is a well-known primary factor indicating glaucoma. In this study, we demonstrate a smart IOP sensor embedded in a contact lens that works through visual color changes without an external power source such as a battery or RF-based wireless power transfer. A microhydraulic amplification mechanism is adopted to enhance the range of color change from a photonic crystal (PC)-based flexible membrane whose lattice distance between nanostructures varies according to the morphology changes of an eyeball caused by IOP. The performance of the sensor is quantitatively demonstrated using an artificial silicone eye model for in vitro evaluation and a porcine eyeball for ex vivo verification. It has a limit of detection (LOD) of 3.2 and 5.12 mmHg, which was measured and evaluated using a spectrometer and a smartphone camera, respectively. The results prove that our sensor embedded in the contact lens can continuously monitor the IOP change using color change, and a smartphone camera can be used as a quantitative IOP measurement system in a noninvasive manner without an expensive optical spectrometer.
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Affiliation(s)
- Bohee Maeng
- Department of Mechanical Engineering, Sogang University, 35 Baekbeom-ro, Mapo-gu, Seoul 04107, Republic of Korea.
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Xu J, Cui T, Hirtz T, Qiao Y, Li X, Zhong F, Han X, Yang Y, Zhang S, Ren TL. Highly Transparent and Sensitive Graphene Sensors for Continuous and Non-invasive Intraocular Pressure Monitoring. ACS APPLIED MATERIALS & INTERFACES 2020; 12:18375-18384. [PMID: 32223262 DOI: 10.1021/acsami.0c02991] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intraocular pressure (IOP) is the prime indicator for the diagnosis and treatment of glaucoma. IOP has circadian rhythm changes and is dependent on body gestures; therefore, a single measurement in the clinic can be misleading for diagnosis. Herein, few-layer graphene is utilized to develop non-invasive sensors with high transparency, sensitivity, linearity, and biocompatibility for 24 h continuous IOP monitoring. The graphene Wheatstone bridge consisting of two strain gauges and two compensating resistors is designed to improve the sensitivity and accuracy of IOP measurement. Testing results on a silicone eyeball indicate that the output voltage of the sensor is proportional to the IOP fluctuation. Under the various ranges and speeds of IOP fluctuation, the sensor exhibits excellent performance of dynamic cycles and step responses with an average sensitivity of 150 μV/mmHg. With the linear relationship, the average relative error between the calibrated IOP and the standard pressure is maintained at about 5%. More than 100 cycles and interval time measurements illustrate that the sensor possesses significant stability, durability, and reliability. Furthermore, a wireless system is designed for the sensor to realize IOP monitoring using a mobile phone. This sensor, with the average transparency of 85% and its ease of fabrication, as well as its portability for continuous IOP monitoring, brings new promise to the diagnosis and treatment of glaucoma.
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Affiliation(s)
- Jiandong Xu
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Tianrui Cui
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Thomas Hirtz
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Yancong Qiao
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Xiaoshi Li
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Fanhui Zhong
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Xiaolin Han
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Yi Yang
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
| | - Sheng Zhang
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, P. R. China
| | - Tian-Ling Ren
- Institute of Microelectronics, Tsinghua University, Beijing 100084, P. R. China
- Beijing National Research Center for Information Science and Technology (BNRist), Tsinghua University, Beijing 100084, P. R. China
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Zakrzewska A, Wiącek MP, Machalińska A. Impact of corneal parameters on intraocular pressure measurements in different tonometry methods. Int J Ophthalmol 2019; 12:1853-1858. [PMID: 31850168 DOI: 10.18240/ijo.2019.12.06] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/29/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the impact of central corneal thickness (CCT) and corneal curvature on intraocular pressure (IOP) measurements performed by three different tonometers. METHODS IOP in 132 healthy eyes of 66 participants was measured using three different tonometry techniques: Goldmann applanation tonometer (GAT), Pascal dynamic contour tonometer (DCT), and ICare rebound tonometer (RT). CCT and corneal curvature were assessed. RESULTS In healthy eyes, DCT presents significantly higher values of IOP than GAT (17.34±3.69 and 15.27±4.06 mm Hg, P<0.0001). RT measurements are significantly lower than GAT (13.56±4.33 mm Hg, P<0.0001). Compared with GAT, DCT presented on average 2.51 mm Hg higher values in eyes with CCT<600 µm and 0.99 mm Hg higher results in eyes with CCT≥600 µm. The RT results were lower on average by 1.61 and 1.95 mm Hg than those obtained by GAT, respectively. Positive correlations between CCT in eyes with CCT<600 µm were detected for all IOP measurement techniques, whereas a similar relationship was not observed in eyes with thicker corneas. A correlation between IOP values and keratometry in the group with CCT<600 µm was not detected with any of the tonometry methods. In thicker corneas, a positive correlation was found for GAT and mean keratometry values (R=0.369, P=0.005). CONCLUSION The same method should always be chosen for routine IOP control, and measurements obtained by different methods cannot be compared. All analysed tonometry methods are dependent on CCT; thus, CCT should be taken into consideration for both diagnostics and monitoring.
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Affiliation(s)
- Aleksandra Zakrzewska
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Marta P Wiącek
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Anna Machalińska
- First Department of Ophthalmology, Pomeranian Medical University, Szczecin 70-111, Poland
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Intraocular pressure measurement after corneal transplantation. Surv Ophthalmol 2019; 64:639-646. [DOI: 10.1016/j.survophthal.2019.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 11/20/2022]
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Comparison of IOP Measurement by Goldmann Applanation Tonometer, ICare Rebound Tonometer, and Tono-Pen in Keratoconus Patients after MyoRing Implantation. J Ophthalmol 2019; 2019:1964107. [PMID: 31210982 PMCID: PMC6532290 DOI: 10.1155/2019/1964107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 04/01/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the different IOP readings by Goldmann applanation tonometer (GAT), ICare rebound tonometer, and Tono-Pen in keratoconus patients after MyoRing implantation. To assess the influence of central corneal thickness (CCT) and thinnest corneal location (TCL) on IOP measurements by different tonometers. Setting. Prospective observational study was conducted in two private centers in Egypt from February 2015 to November 2016. Methods. Seventeen eyes of 10 patients suffering from keratoconus and who underwent MyoRing implantation were recruited. All subjects underwent GAT, ICare, and Tono-Pen IOP measurements in random order. Central corneal thickness and thinnest corneal location were assessed by Pentacam. Difference in mean in IOP readings was assessed by T-test. Correlation between each pair of devices was evaluated by Pearson correlation coefficient. The Bland–Altman analysis was used to assess intertonometer agreement. Results. Seventeen eyes (10 patients) were evaluated. The mean IOP reading was 13.9 ± 3.68, 12.41 ± 2.87, and 14.29 ± 1.31 mmHg in GAT, ICare, and Tono-Pen group, respectively. There was a significant difference between IOP readings by GAT/ICare and Tono-Pen/ICare (p value: 0.032 and 0.002, respectively) with no significant difference between GAT/Tono-Pen (p value: 0.554). Mean difference in IOP measurements between GAT/ICare was 1.49 ± 2.61 mmHg, Tono-Pen/ICare was 1.89 ± 2.15 mmHg, and GAT/Tono-Pen was −0.39 ± 2.59 mmHg. There was no significant correlation between the difference in IOP readings among any pair of devices and CCC or TCL. The Bland–Altman analysis showed a reasonable agreement between any pair of tonometers.
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Goldmann Applanation Tonometer Versus Ocular Response Analyzer for Measuring Intraocular Pressure After Descemet Stripping Automated Endothelial Keratoplasty. Cornea 2018; 37:1370-1375. [DOI: 10.1097/ico.0000000000001660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Can Corneal Biomechanical Properties Explain Difference in Tonometric Measurement in Normal Eyes? Optom Vis Sci 2018; 95:120-128. [DOI: 10.1097/opx.0000000000001175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kim JW, Jung JW. Clinical Evaluation of a Rebound Tonometer in Patients Who Underwent Penetrating Keratoplasty. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.12.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Woo Kim
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Jung
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
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Glaucoma after corneal replacement. Surv Ophthalmol 2017; 63:135-148. [PMID: 28923582 DOI: 10.1016/j.survophthal.2017.09.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 01/18/2023]
Abstract
Glaucoma is a well-known complication after corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty, has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with penetrating keratoplasty. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser, or surgical therapy.
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Ohana O, Varssano D, Shemesh G. Comparison of intraocular pressure measurements using Goldmann tonometer, I-care pro, Tonopen XL, and Schiotz tonometer in patients after Descemet stripping endothelial keratoplasty. Indian J Ophthalmol 2017; 65:579-583. [PMID: 28724814 PMCID: PMC5549409 DOI: 10.4103/ijo.ijo_31_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Post-Descemet stripping endothelial keratoplasty (DSEK) patients are prone for intraocular pressure (IOP) elevations and glaucoma. Corneal characteristics influence various IOP measuring devices in various ways. The aim of this study was to evaluate the agreement between four different IOP measuring devices: Goldmann applanation tonometer (GAT), I-care pro, Tonopen XL, and Schiotz tonometr in patients who underwent DSEK. METHODS This was a prospective comparative study using a convenience cohort of post-DSEK patients with compact grafts. Post-DSEK patients had IOP measured using GAT, I-care Pro, Tonopen XL, and Schiotz tonometer. Measurements were compared and agreement assessed. Wilcoxon signed-rank test was used for comparison of means as variables did not show a normal distribution. Bland-Altman plots were used for assessing agreement. RESULTS Thirty eyes of 24 patients were included in the study. Mean time from DSEK surgery was 25.31 ± 13.05 months. Mean IOP with GAT, I-care pro, Tonopen XL, and Schiotz tonometer was 13.99 ± 3.76, 13.92 ± 3.36, 13.31 ± 3.89, and 12.83 ± 4.07, respectively. GAT, I-care pro, and Tonopen XL had similar mean IOP measurements (P = 0.135 and P = 0.551, respectively), while Schiotz tonometry measurements were higher (P = 0.046). Bland-Altman plots show good agreement between GAT, Tonopen XL, and I-care pro. GAT and Schiotz tonometry show less agreement, with large variations in the differences of measured IOP. CONCLUSIONS IOP measurements in post-DSEK patients showed good agreement between GAT and either Tonopen XL or I-care pro. Schiotz tonometer has large variations in this patient group. IOP measurements and IOP difference between devices were not dependent on central corneal thickness.
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Affiliation(s)
- Oded Ohana
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Varssano
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Shemesh
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract
Penetrating keratoplasty is a surgical intervention that despite the progress of surgical techniques and of postoperative treatment continues to have numerous complications. Many of them, such as graft rejection, significant astigmatism, cystoid macular edema, or cataract lead to important limitations of the visual function. Glaucoma is possibly the most dangerous complication following PK, leading to loss of the visual potential of the eye due to irreversible damage to the optic nerve. Identifying the risk factors permits an attentive follow-up and rapid treatment of the postoperative IOP rises. Maybe the most important is that preexisting glaucoma should be rightly diagnosed and controlled before PK, medically or, if necessary, surgically. Abbreviations: PK = penetrating keratoplasty, IOP = intraocular pressure, PAS = peripheral anterior synechiae, TM = trabecular meshwork, DM = Descemet membrane, GAT = Goldmann applanation tonometry, MMC = mitomycin C, CAI = carbonic anhydrase inhibitors, 5-FU = 5-fluorouracil.
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Affiliation(s)
- Mihail Zemba
- Department of Ophthalmology, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alina-Cristina Stamate
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Arena Med Clinic, Bucharest, Romania
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Tarkkanen A, Puska P, Kivelä T. Home- or self-tonometry to the follow-up of intraocular pressure in glaucoma. Acta Ophthalmol 2016; 94:e803-e804. [PMID: 27683192 DOI: 10.1111/aos.13270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ahti Tarkkanen
- Department of Ophthalmology; Helsinki University Central Hospital; Helsinki Finland
| | - Päivi Puska
- Department of Ophthalmology; Helsinki University Central Hospital; Helsinki Finland
| | - Tero Kivelä
- Department of Ophthalmology; Helsinki University Central Hospital; Helsinki Finland
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Achiron A, Blumenfeld O, Avizemer H, Karmona L, Leybowich G, Man V, Bartov E, Burgansky-Eliash Z. Intraocular pressure measurement after DSAEK by iCare, Goldmann applanation and dynamic contour tonometry: A comparative study. J Fr Ophtalmol 2016; 39:822-828. [PMID: 27871779 DOI: 10.1016/j.jfo.2016.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/18/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Corneal thickness inevitably increases following Descemet's stripping automated endothelial keratoplasty (DSAEK), owing to the addition of a donor graft. The current study compares different devices in assessing post-DSAEK intraocular pressure (IOP). METHODS We compared IOP values measured by the Goldmann tonometry (GAT), iCare rebound tonometry (iCare) and Pascal dynamic contour tonometry (PDCT) in eyes following DSAEK. Agreement between measurements was calculated with correlation analysis and Bland-Altman plots. Effects of keratometry, central, thickness (CCT), endothelial cell density (ECD) and axial length on IOP measurements were assessed with Pearson's correlation. RESULTS Twenty eyes of 20 patients (mean age 74.3±14.4, 14 females) post-DSAEK were included in this study. There was a high concordance between the IOP readings obtained by the three devices: a strong and significant correlation was found between GAT and PDCT (r=0.94, P<0.001) GAT and iCare (r=0.86, P<0.001) and iCare with PDCT (r=0.81, P<0.001). However, the iCare measurements were significantly and consistently lower than that obtained with GAT (ΔIOP=1.68±2.0, P=0.002, 95% CI: 0.7-2.6) and with PDCT (ΔIOP=1.61±2.5, P=0.01, 95% CI: 0.4-2.8). CCT, ECD, CCT, AXL, corneal curvature or astigmatism did not influence IOP measurement by any instrument. CONCLUSIONS IOP measurement with three different techniques (applanation, rebound and dynamic contour) showed good correlations, despite an increased corneal thickness following DSAEK. However, the iCare, which is based on a rebound tonometry showed significant lower IOP then the two other methods. This should be taken into account when evaluating patients post DSAEK.
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Affiliation(s)
- A Achiron
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - O Blumenfeld
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - H Avizemer
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - L Karmona
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - G Leybowich
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - V Man
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University, Beer-Sheva, Israel
| | - E Bartov
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Z Burgansky-Eliash
- Department of Ophthalmology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Zeri F, De Cusatis M, Lupelli L, Swann PG. The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry. JOURNAL OF OPTOMETRY 2016; 9:182-188. [PMID: 26499996 PMCID: PMC4912530 DOI: 10.1016/j.optom.2015.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 07/17/2015] [Accepted: 08/03/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. METHODS The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects' right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. RESULTS The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. CONCLUSIONS Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result did not change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses.
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Affiliation(s)
- Fabrizio Zeri
- Degree Course in Optics and Optometry, Department of Sciences - Roma TRE University, Rome, Italy; Vision Sciences Department, Istituto Benigno Zaccagnini, Bologne, Italy; School of Life and Health Sciences, Aston University, Birmingham, UK.
| | - Mario De Cusatis
- Degree Course in Optics and Optometry, Department of Sciences - Roma TRE University, Rome, Italy
| | - Luigi Lupelli
- Degree Course in Optics and Optometry, Department of Sciences - Roma TRE University, Rome, Italy; Vision Sciences Department, Istituto Benigno Zaccagnini, Bologne, Italy; School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Peter Graham Swann
- School of Optometry, Hong Kong Polytechnic University, Hong Kong; School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Abstract
PURPOSE OF REVIEW Intraocular pressure (IOP) elevation and glaucoma progression following corneal transplantation, specifically, penetrating keratoplasty, Descemet's stripping endothelial keratoplasty, and Boston keratoprosthesis, are well described causes of ocular morbidity. Depending on the procedure performed, the incidence of glaucoma is highly variable. Several etiologic factors have been identified, the most common being synechial angle closure and corticosteroid-induced IOP elevation. The purpose of this review is to describe the various treatment strategies for glaucoma following corneal transplantation. RECENT FINDINGS Medications and laser treatments are usually first-line therapies for postoperative IOP elevation. Surgical intervention, including filtering surgery and glaucoma drainage devices, may be necessary to control IOP and prevent progressive glaucomatous damage. SUMMARY Glaucoma is a common complication of corneal transplantation, and the degree of aggressiveness is often related to the indication for corneal surgery. Although postoperative IOP elevation may be controlled with medical therapy alone, refractory cases may require glaucoma surgery. In all cases, early detection and intervention are necessary to optimize patient outcomes.
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Clement CI, Parker DGA, Goldberg I. Intra-Ocular Pressure Measurement in a Patient with a Thin, Thick or Abnormal Cornea. Open Ophthalmol J 2016; 10:35-43. [PMID: 27014386 PMCID: PMC4780515 DOI: 10.2174/1874364101610010035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/23/2022] Open
Abstract
Accurate measurement of intra-ocular pressure is a fundamental component of the ocular examination. The most common method of measuring IOP is by Goldmann applanation tonometry, the accuracy of which is influenced by the thickness and biomechanical properties of the cornea. Algorithms devised to correct for corneal thickness to estimate IOP oversimplify the effects of corneal biomechanics. The viscous and elastic properties of the cornea influence IOP measurements in unpredictable ways, a finding borne out in studies of patients with inherently abnormal and surgically altered corneal biomechanics. Dynamic contour tonometry, rebound tonometry and the ocular response analyzer provide useful alternatives to GAT in patients with abnormal corneas, such as those who have undergone laser vision correction or keratoplasty. This article reviews the various methods of intra-ocular pressure measurement available to the clinician and the ways in which their utility is influenced by variations in corneal thickness and biomechanics.
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Affiliation(s)
- Colin I Clement
- Eye Associates, 4/187 Macquarie Street Sydney NSW 2000, Australia; Glaucoma Unit, Sydney Eye Hospital, Australia; Discipline of Ophthalmology, The University of Sydney, Australia; Gosford and Wyong Eye Surgery, Australia
| | - Douglas G A Parker
- Eye Associates, 4/187 Macquarie Street Sydney NSW 2000, Australia; Gosford and Wyong Eye Surgery, Australia
| | - Ivan Goldberg
- Eye Associates, 4/187 Macquarie Street Sydney NSW 2000, Australia; Glaucoma Unit, Sydney Eye Hospital, Australia; Discipline of Ophthalmology, The University of Sydney, Australia
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McKee EC, Ely AL, Duncan JE, Dosunmu EO, Freedman SF. A comparison of Icare PRO and Tono-Pen XL tonometers in anesthetized children. J AAPOS 2015; 19:332-7. [PMID: 26235790 DOI: 10.1016/j.jaapos.2015.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/12/2015] [Accepted: 04/25/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tonometry in the anesthetized child, vital for evaluating known or suspected glaucoma, remains limited to tonometers capable of supine recording. The Icare PRO measures intraocular pressure (IOP) in the sitting or supine patient. The purpose of this study was to compare Icare PRO and Tono-Pen tonometry during examination under anesthesia in eyes of supine children with normal eyes and glaucoma and/or corneal pathology. METHODS In this prospective study of children undergoing examination under anesthesia, IOP was recorded in both eyes with Icare PRO and Tono-Pen immediately after mask anesthesia induction, with instrument order randomized. RESULTS A total of 100 eyes of 50 children (median age, 58 months) were included. IOP range was 6-50 mm Hg by Icare PRO and 6-53 mm Hg by Tono-Pen. Mean IOP measured by Tono-Pen (18.9 ± 7.5) was higher than that measured by Icare PRO (16.7 ± 7.1 mm Hg) by 2.2 mm Hg (P < 0.001). The presence of corneal edema was associated with IOP measurements higher by Tono-Pen than by Icare PRO (mean difference, 8.4 mm Hg). When eyes with corneal edema were excluded from analysis, there was no correlation between central corneal thickness and the difference in IOP between the two instruments. CONCLUSIONS IOP in eyes of supine children under anesthesia measured approximately 2 mm Hg higher by Tono-Pen than Icare PRO and this difference was greater in eyes with frank corneal edema. Icare PRO may become a valuable tool for tonometry in supine infants and children, but a confirmatory test should be considered in eyes with corneal edema.
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Tam�elik N, Atalay E, Cicik E, �zk�k A. Comparability of Icare Pro Rebound Tonometer with Goldmann Applanation and Noncontact Tonometer in a Wide Range of Intraocular Pressure and Central Corneal Thickness. Ophthalmic Res 2015; 54:18-25. [DOI: 10.1159/000381781] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/17/2015] [Indexed: 11/19/2022]
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Abstract
Glaucoma is the leading cause of irreversible vision loss post-keratoplasty and an important cause of graft failure. With newer techniques, such as lamellar, endothelial, and laser-assisted keratoplasty as well as keratoprosthesis gaining popularity, clinicians will need to consider the incidence, risks, evaluation, and management of glaucoma for each type of keratoplasty when determining which type of transplant may be most appropriate. A comprehensive literature search of glaucoma in the setting of corneal transplantation was performed and serves as the basis for this review. Preexisting glaucoma and aphakia are notable risk factors. Patients that are candidates for deep anterior lamellar keratoplasty may benefit from reduced rates of post-keratoplasty glaucoma. Although glaucoma also complicates eyes with Descemet stripping endothelial keratoplasty, the severity is less and the intraocular pressure is more easily controlled when compared to penetrating keratoplasty. Endothelial keratoplasty creates unique perioperative issues mostly related to management of anterior chamber air bubbles.
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Affiliation(s)
- Ramez I Haddadin
- Massachusetts Eye & Ear Infirmary, Ophthalmology, Cornea & Refractive Surgery Service, Harvard Medical School , Boston, Massachusetts , USA
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Measuring Intraocular Pressure After Intrastromal Corneal Ring Segment Implantation With Rebound Tonometry and Goldmann Applanation Tonometry. Cornea 2015; 34:516-20. [DOI: 10.1097/ico.0000000000000374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sinha G, Gupta S, Temkar S, Pandey V, Sihota R, Dada T. IOP agreement between I-Care TA01 rebound tonometer and the Goldmann applanation tonometer in eyes with and without glaucoma. Int Ophthalmol 2014; 35:89-93. [DOI: 10.1007/s10792-014-0026-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 12/01/2014] [Indexed: 11/28/2022]
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Fuest M, Mamas N, Walter P, Plange N. Tonometry in Corneal Edema after Cataract Surgery: ReboundversusGoldmann Applanation Tonometry. Curr Eye Res 2014; 39:902-7. [DOI: 10.3109/02713683.2014.888451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Moisseiev E, Varssano D, Rosenfeld E, Rachmiel R. Intraocular pressure after penetrating keratoplasty and Descemet's stripping automated endothelial keratoplasty. Can J Ophthalmol 2014; 48:179-85. [PMID: 23769779 DOI: 10.1016/j.jcjo.2013.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 12/29/2012] [Accepted: 01/03/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the intraocular pressure (IOP) during the first postoperative year after penetrating keratoplasty (PK) and Descemet's stripping automated endothelial keratoplasty (DSAEK). DESIGN Retrospective chart review. PARTICIPANTS Fifty-three pseudophakic eyes of 53 patients who underwent PK or DSAEK because of endothelial dysfunction between January 2006 and December 2010 were included. METHODS Surgeries consisted of 19 (35.8%) PK procedures and 34 (64.2%) DSAEK procedures. Demographic, preoperative, and postoperative data including IOP, number of medications, rejection and occurrence, and complications were recorded. RESULTS Patients who had undergone DSAEK had statistically significant lower IOP throughout 12 months after surgery than those who had undergone PK (p = 0.028), despite similar use of IOP-lowering medications during this time. Measurements of postoperative IOP greater than 21 mm Hg and greater than 30 mm Hg were significantly more common in patients who had undergone PK than DSAEK (p = 0.015 and 0.022, respectively). Complication rates were similar between the 2 groups. IOP was not correlated with patient age, sex, background illnesses, or previous glaucoma. CONCLUSIONS IOP is significantly lower after DSAEK compared with PK. Several mechanisms explaining this difference are proposed. New corneal transplantation modalities such as DSAEK, with a better postoperative IOP control, may reduce the risk for later visual loss caused by postoperative glaucomatous damage.
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Affiliation(s)
- Elad Moisseiev
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Barkana Y, Gutfreund S. Measurement of the difference in intraocular pressure between the sitting and lying body positions in healthy subjects: direct comparison of the Icare Pro with the Goldmann applanation tonometer, Pneumatonometer and Tonopen XL. Clin Exp Ophthalmol 2014; 42:608-14. [PMID: 24299102 DOI: 10.1111/ceo.12272] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 11/18/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Change in intraocular pressure is known to occur with body posture. Previously, markedly different estimations of this change were reported. The Icare Pro (Icare; Tiolat Oy, Helsinki, Finland) is designed to measure intraocular pressure with the subject supine. We compared the measurement of postural change in intraocular pressure obtained with this and 3 other tonometers: Goldmann applanation tonometer (CSO, Firenze, Italy), Pneumatonometer (Model 30, Reichert, Depew, NY, USA) and the Tonopen XL (Reichert). DESIGN Prospective comparative study. PARTICIPANTS Twenty-one healthy subjects. METHODS Intraocular pressure was measured in random order with four tonometers, first sitting then after 10 min of lying. MAIN OUTCOME MEASURES Average postural intraocular pressure change (mmHg) and the 95% limits of agreement for measuring postural intraocular pressure change between tonometers. RESULTS Average postural intraocular pressure change (lying minus sitting, mmHg) was measured highest with the Goldmann applanation tonometer (4.1 ± 2.6) and Pneumatonometer (3.9 ± 2.1), significantly lower with the Tonopen (0.9 ± 1.7) and was negative with the Icare (-0.9 ± 3.3). The 95% limits of agreement for measuring postural intraocular pressure change between Goldmann applanation tonometer and Icare, Pneumatonometer and Tonopen were -3.2-13.3, -6.4-6.9 and -2.8-9.4 mmHg, respectively. CONCLUSIONS Postural change in intraocular pressure was measured similarly, on average, with Goldmann applanation tonometer and Pneumatonometer, and much lower with Tonopen and Icare Pro. There was poor interdevice agreement in measuring this parameter. We observed high intersubject variability, suggesting the clinical importance of this measurement in the diagnosis and management of glaucoma.
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Affiliation(s)
- Yaniv Barkana
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel
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Olafsdottir OB, Vandewalle E, Abegão Pinto L, Geirsdottir A, De Clerck E, Stalmans P, Gottfredsdottir MS, Kristjansdottir JV, Van Calster J, Zeyen T, Stefánsson E, Stalmans I. Retinal oxygen metabolism in healthy subjects and glaucoma patients. Br J Ophthalmol 2014; 98:329-33. [DOI: 10.1136/bjophthalmol-2013-303162] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Wang X, Dong J, Wu Q. Twenty-four-hour measurement of IOP in rabbits using rebound tonometer. Vet Ophthalmol 2013; 16:423-8. [PMID: 23279703 DOI: 10.1111/vop.12020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Xiaogang Wang
- Department of Ophthalmology; Affiliated Sixth People's Hospital Shanghai Jiao Tong University; Shanghai China
| | - Jing Dong
- Department of Ophthalmology; The First Hospital of Shanxi Medical University; Shanxi China
| | - Qiang Wu
- Department of Ophthalmology; Affiliated Sixth People's Hospital Shanghai Jiao Tong University; Shanghai China
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Lee K, Lee JY, Moon JI, Park MH. Comparison of Icare Rebound Tonometer with Goldmann Applanation Tonometry. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.2.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kook Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jung Il Moon
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Myoung Hee Park
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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