1
|
Muhsen S, Rabadi A, Alqudah M, Obiedat A, Owies L, Alhawaniah I, Abdel Hafez S, Al-Ani A. Validation of intraocular pressure measurement using tonometer AVIA across different postures: A Bland Altman analysis. Eur J Ophthalmol 2024:11206721241247672. [PMID: 38623622 DOI: 10.1177/11206721241247672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
AIMS/OBJECTIVES Tonometry is a fundamental procedure in the diagnosis and management of glaucoma. Different tonometers have been proposed but none are as accurate as the Goldman applanation tonometry (GAT). Nonetheless, due to the limitations of GAT, mobile tonometry methods became prevalent. This study aims to examine the reliability of the Tono-Pen AVIA® (TPA) in measuring intraocular pressure (IOP) across different postures. METHODS A total of 196 eyes were prospectively examined for IOP changes using GAT and TPA. IOP measurements were taken across different postures using the TPA. Reliability of measurements was compared using interclass correlation coefficients (ICC), while agreement was represented using Bland-Altman analysis. Pearson r coefficient was used to measure correlations. RESULTS When compared to GAT (14.5 ± 4.4 mmHg), IOP readings were significantly higher for TPA at both seated (16.5 ± 4.5 mmHg; p < 0.001) and supine (16.9 ± 5.7; p < 0.001) positions. The ICC values for GAT and TPA among seated and supine patients were 0.79 (0.54-0.90) and 0.76 (0.48-0.87) indicating good reliability between the readings. There were significantly positive correlations between GAT and TPA at both seated (r = 0.626, p < 0.001) and supine (r = 0.727, p < 0.001) positions. Per Bland-Altman analysis, limits of agreement were -8.57 to 4.37 for GAT and seated TPA and -10.34 and 5.34 for GAT and supine TPA. CONCLUSION Good reliability exists between IOP measurements using GAT and TPA. However, the devices are not interchangeable and therefore cannot be used reciprocally in the same patient.
Collapse
Affiliation(s)
- Sana' Muhsen
- Special Surgery Department/Ophthalmology Division, School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | - Liyana Owies
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| |
Collapse
|
2
|
Carlisle A, Habib S, Lin Z, Ching J, Niyadurupola N. Do ophthalmology residents know how to check the calibration of a Goldmann applanation tonometer? Int Ophthalmol 2023; 43:3595-3600. [PMID: 37355488 DOI: 10.1007/s10792-023-02766-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE The purpose of this observational study was to determine whether ophthalmology residents know how to check Goldmann applanation tonometer (GAT) calibration. METHODS The step-by-step technique for checking the calibration of a GAT was taken from the manufacturer's manual and developed into a mark sheet. Ophthalmology residents in years 2-8 of training from 11 hospitals were individually observed and assessed checking calibration of a GAT. Participation was voluntary. Contact between participants was minimised to prevent communication about the study. RESULTS Sixty-eight per cent (n = 30) of eligible ophthalmology residents (years 2-8) from 11 hospitals (three teaching hospitals and eight local general hospitals) were observed checking GAT calibration. Only 33% (n = 10; 95% CI: 16-50%) of ophthalmology residents were able to correctly check GAT calibration. Those participants who were previously taught (p = 0.046) or assessed (p = 0.015) were more likely to be successful in GAT calibration. CONCLUSIONS Most ophthalmology residents were unable to correctly check GAT calibration. Although better than previously published results, this observational study shows that further training and assessment is required for ophthalmology residents to learn the technique of checking GAT calibration.
Collapse
Affiliation(s)
- Aaron Carlisle
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Sofia Habib
- Department of Ophthalmology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Zhiheng Lin
- Department of Ophthalmology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Jared Ching
- Department of Ophthalmology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Nuwan Niyadurupola
- Department of Ophthalmology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| |
Collapse
|
3
|
Chagny M, Stolowy N, Denis D, Sauvan L. Comparison of the iCare rebound tonometer and the Perkins applanation tonometer in children under general anesthesia. J Fr Ophtalmol 2023:S0181-5512(23)00191-2. [PMID: 37210292 DOI: 10.1016/j.jfo.2022.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 05/22/2023]
Abstract
INTRODUCTION The goal of the study was to compare Perkins applanation tonometry and iCare rebound tonometry, evaluating their correlation and agreement in a diverse pediatric population under general anaesthesia (GA). MATERIALS AND METHODS Children undergoing an eye examination under GA between November 2019 and March 2020 were included. Intraocular pressure (IOP) was measured successively using the Perkins applanation tonometer and the iCare IC200 rebound tonometer. Ultrasonic central pachymetry and axial length were measured. RESULTS One hundred and thirty-eight eyes of 72 children were included. The mean age was 2.87years. IOP measurements obtained with the two tonometers were statistically and significantly highly correlated (r=0.8, P<0.001), although the iCare overestimated IOP by an average of 3.37mmHg (SD±4.48). The agreement between the two methods was moderate; the 95% agreement limits ranged from -5.41 to +12.15mmHg (r=0.5, P<0.001). The IOP difference between the two tonometers was weakly but significantly correlated with mean IOP (r=0.52; P=0.006). No correlation was found with axial length and pachymetry. CONCLUSION In this study, the IOP values obtained using the Perkins applanation tonometer and the iCare IC200 rebound tonometer were well correlated. The iCare tended to overestimate the IOP, especially for high IOP values. However, no underestimation of IOP was found with this device, hence its potential for glaucoma screening in children.
Collapse
Affiliation(s)
- M Chagny
- CHU Nord Marseille, chemin des Bourrely, 13015 Marseille, France
| | - N Stolowy
- CHU Nord Marseille, chemin des Bourrely, 13015 Marseille, France.
| | - D Denis
- CHU Nord Marseille, chemin des Bourrely, 13015 Marseille, France
| | - L Sauvan
- CHU Nord Marseille, chemin des Bourrely, 13015 Marseille, France
| |
Collapse
|
4
|
Ang RET, Rixon A, Kilgore K, Schweitzer J. Goldmann and modified Goldmann tonometry measuring intraocular pressure changes in eyes which underwent myopic laser in situ Keratomileusis and photorefractive keratectomy. BMC Ophthalmol 2022; 22:503. [PMID: 36539706 PMCID: PMC9768993 DOI: 10.1186/s12886-022-02741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Compare intraocular pressure (IOP) measured by a standard Goldmann applanation tonometer prism (IOPg) and a modified correcting applanation tonometer surface Goldmann prism (IOPc) before and after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). METHODS Goldmann tonometry was analyzed in a retrospective, cross-sectional study, using both GAT and modified-GAT prisms pre-operatively and at the 3 month post-operative appointment on 120 eyes (64 patients) who received LASIK (n = 58) or PRK (n = 62). Demographics, central corneal thickness (CCT), manifest refraction and corneal curvature (CC) data was collected at each visit as well as surgical parameters, including maximum ablation depth. RESULTS Mean paired IOP following LASIK decreased by - 3.28 ± 3.2 mmHg measured by IOPg and - 1.93 ± 3.3 mmHg by IOPc (p ≤ 0.0001). Mean paired IOP following PRK reduced by - 1.92 ± 3.6 mmHg measured by IOPg and - 1.06 ± 3.6 mmHg by IOPc (p ≤ 0.0001). Increased LASIK ablation depth and post-procedural change in CCT trended toward a statistically significant reduction in IOPg (p = 0.07,p = 0.12), but not IOPc (p = 0.18,p = 0.32). PRK ablation depth was not associated with a reduction in IOPg or IOPc. DISCUSSION The modified Goldmann (IOPc) prism measured less of an IOP reduction following LASIK and PRK compared to the standard (IOPg) prism, and the IOP reduction with both prisms was associated with the degree of myopic correction. WHAT IS ALREADY KNOWN AND THE RESIDUAL QUERY Corneal refractive surgery generally demonstrates significant postoperative Goldmann IOP reductions. Presumably, this is due to corneal biomechanical changes for which a newer method of Goldmann IOP measurement may be able to compensate. WHAT THIS STUDY ADDS A modified, corneal conforming Goldmann prism demonstrates significantly less IOP reduction following myopic LASIK and PRK compared to the standard flat Goldmann prism. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY A newer, modified Goldmann prism may help detect glaucoma and OHT at an earlier stage in patients which have undergone LASIK or PRK. The findings corroborate predicted corneal biomechanical changes following the most common corneal refractive procedures.
Collapse
Affiliation(s)
- Robert Edward T. Ang
- Department of Ophthalmology, Cardinal Santos Medical Center, City, Metro Manila, San Juan, Philippines ,grid.476917.a0000 0004 9154 7342Cornea and Refractive Surgery Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines ,grid.476917.a0000 0004 9154 7342Glaucoma Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines
| | - Andrew Rixon
- grid.413847.d0000 0004 0420 4721Veterans Administration, Memphis, TN U.S.A.
| | | | | |
Collapse
|
5
|
Gün RD, Şimşek Ş. Effect of manual upper eyelid elevation on intraocular pressure measurement by noncontact tonometer. Int Ophthalmol 2022. [PMID: 35556201 DOI: 10.1007/s10792-022-02324-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate whether manual upper eyelid elevation (MUEE) affects intraocular pressure (IOP) values obtained with a noncontact tonometer (NT). METHODS This cross-sectional study included 122 eyes of 122 non-glaucomatous adults. All patients underwent IOP measurement using both NT and Goldmann applanation tonometer (GAT). The order of measurements was NT without MUEE, NT with MUEE, and GAT. Both eyes of each patient were measured and one of the eyes was randomly selected for inclusion in the study. Central corneal thickness (CCT) and palpebral fissure height (PFH; distance between upper and lower eyelids) was recorded. RESULTS The patients' mean age was 43.91 ± 12.36 (20-61) years and 62.3% were women. Mean IOP values measured by NT without MUEE, NT with MUEE, and GAT were 15.98 ± 2.39, 15.84 ± 2.53, and 14.33 ± 2.3 mmHg, respectively. There was no statistically significant difference in mean IOP between NT without and with MUEE (p = 0.506). Mean IOP values obtained by NT with and without MUEE were significantly higher than those obtained by GAT (p < 0.001). The difference in IOP values measured by NT without and with MUEE was positively correlated with PFH (r = 0.214; p = 0.018). CCT and IOP values obtained by NT without MUEE and GAT were positively correlated (r = 0.300; p = 0.001 and r = 0.311; p = 0.001, respectively). CONCLUSION MUEE does not have a significant effect on IOP measurements by NT. The difference between IOP measured by NT without and with MUEE increases with greater PFH.
Collapse
|
6
|
Serafino M, Villani E, Lembo A, Rabbiolo G, Specchia C, Trivedi RH, Nucci P. A comparison of Icare PRO and Perkins tonometers in anesthetized children. Int Ophthalmol 2019; 40:19-29. [PMID: 31313069 DOI: 10.1007/s10792-019-01143-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 07/06/2019] [Indexed: 11/24/2022]
Abstract
AIM To compare intraocular pressure (IOP) measurements obtained with the Perkins applanation tonometer and Icare PRO (ICP) rebound tonometer in anesthetized aphakic or strabismus children. Furthermore, intra-operator correlation and inter-operator correlation have been evaluated, along with the effects of central corneal thickness (CCT) on IOP measurements. METHODS Seventy children undergoing examination under anesthesia with sevoflurane for aphakic patients and for surgery for strabismus were included. IOP have been measured twice immediately after anesthesia induction with both Perkins applanation tonometer (PAT) and ICP in one eye and by two different operators with both devices in the fellow eye. Furthermore, CCT was measured with ultrasound pachymetry Pacline (Optikon). Agreement between the device measurements has been evaluated using Bland-Altman analyses. Repeatability and reproducibility of the device have been evaluated with intraclass correlation coefficient (ICC) with a value > 0.75 associated with excellent reliability. The relationship between IOP and CCT has been evaluated with Spearman's correlation coefficient r and determination coefficient r2. RESULTS Mean difference in IOP measurements between ICP and PAT was 1.97 mmHg ± 1.23 mmHg (p < 0.05). This difference appeared to be higher in aphakic patients (mean difference 2.15 ± 1.35) than in patients undergoing strabismus surgery (mean difference 1.83 mmHg ± 1.12). Intraclass correlation coefficient (ICC) is used to evaluate repeatability and reproducibility, which are both high for PAT (repeatability 0.96, reproducibility 0.76) compared with ICP (repeatability 0.81, reproducibility 0.70). Correlation coefficient between CCT and IOP is 0.66 for both ICP and PAT. CONCLUSION ICP tends to overestimate IOP compared to PAT. Repeatability and reproducibility are both high for PAT as compared to ICP. A significant correlation between IOP and CCT for both instruments has been demonstrated.
Collapse
Affiliation(s)
- Massimiliano Serafino
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy
| | - Edoardo Villani
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy
| | - Andrea Lembo
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy.
| | - Giovanni Rabbiolo
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy
| | - Claudia Specchia
- Department of Molecular and Translational Medicine, Brescia and IRCCS Multimedica, University of Brescia, Milan, Italy
| | - Rupal H Trivedi
- Department of Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA
| | - Paolo Nucci
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy
| |
Collapse
|
7
|
Jasani KM, Putri C, Pearl A, Sattar N, Mercieca K, Spaeth G, Bhan-Bhargava A. Disposable versus non-disposable tonometer prisms: a UK national survey. BMJ Open Ophthalmol 2018; 1:e000019. [PMID: 29354698 PMCID: PMC5721635 DOI: 10.1136/bmjophth-2016-000019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 02/11/2017] [Accepted: 02/14/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the prevalence of disposable tonometer versus non-disposable tonometer use in the UK and to determine methods of decontamination and frequency of replacement of prisms. A total of 137 ophthalmology departments were interviewed by telephone using a structured questionnaire. The main outcome measured were:types of tonometer prisms used in clinic (disposable, non-disposable and/or other) average disposable prisms used per clinic session average lifespan of non-disposable prisms prism preference by glaucoma and other teams within department.
A cost and benefit analysis was then performed on the data acquired. Results One hundred and fifty-five departments were identified for the survey. Of these, 137 (88.3%) responded. Eighty-one departments (59.1%) used Tonosafe prisms alone, whereas 22 departments (16.1%) used Goldmann non-disposable prisms exclusively. Thirty-five departments (64%) on average have a change rate of 26.5% per year (range: 0–100, median: 20) attributed to damage, loss or theft. Sixteen departments (29%) reported that prisms were used until damaged or lost. Four departments (7%) were uncertain of their prism usage and could not provide further information. Conclusions Majority of eye departments in the UK opt for disposable prisms. This survey shows the perceived cost-effectiveness of disposable prisms is overestimated when the true cost of disinfection and damage is taken into account. Significant cost savings coupled with the low risk of infectivity (if decontaminated properly) should prompt clinicians and ophthalmic departments worldwide to reconsider the use of non-disposable prisms.
Collapse
|
8
|
McCafferty S, Levine J, Schwiegerling J, Enikov ET. Goldmann and error correcting tonometry prisms compared to intracameral pressure. BMC Ophthalmol 2018; 18:2. [PMID: 29301514 PMCID: PMC5753488 DOI: 10.1186/s12886-017-0668-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 12/13/2017] [Indexed: 11/14/2022] Open
Abstract
Background Compare Goldmann applanation tonometer (GAT) prism and correcting applanation tonometry surface (CATS) prism to intracameral intraocular pressure (IOP), in vivo and in vitro. Methods Pressure transducer intracameral IOP was measured on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically to 10, 20, and 40 mmHg. Simultaneously, IOP was measured using a Perkins tonometer with a standard GAT prism and a CATS prism at each of the intracameral pressures. Statistical comparison was made between true intracameral pressures and the two prism measurements. Differences between the two prism measurements were correlated to central corneal thickness (CCT) and corneal resistance factor (CRF). Human cadaver eyes were used to assess measurement repeatability. Results The CATS tonometer prism measured closer to true intracameral IOP than the GAT prism by 1.7+/−2.7 mmHg across all pressures and corneal properties. The difference in CATS and GAT measurements was greater in thin CCT corneas (2.7+/−1.9 mmHg) and low resistance (CRF) corneas (2.8+/−2.1 mmHg). The difference in prisms was negligible at high CCT and CRF values. No difference was seen in measurement repeatability between the two prisms. Conclusion A CATS prism in Goldmann tonometer armatures significantly improve the accuracy of IOP measurement compared to true intracameral pressure across a physiologic range of IOP values. The CATS prism is significantly more accurate compared to the GAT prism in thin and less rigid corneas. The in vivo intracameral study validates mathematical models and clinical findings in IOP measurement between the GAT and CATS prisms.
Collapse
Affiliation(s)
- Sean McCafferty
- Department of Ophthalmology, Intuor Technologies, University of Arizona- College of Medicine, University of Arizona- College of Optical Science, LLC 6422 E. Speedway Blvd. Suite 100, Tucson, AZ, 85710, USA. .,Department of Ophthalmology, University of Arizona- College of Medicine, 6422 E. Speedway Blvd. Suite 100, Tucson, AZ, 85710, USA. .,Department of Aerospace and Mechanical, University of Arizona-College of Engineering, 1130 N. Mountain Ave, Tucson, AZ, 85721, USA. .,, Tucson, USA.
| | - Jason Levine
- Department of Ophthalmology, University of Arizona- College of Medicine, 6422 E. Speedway Blvd. Suite 100, Tucson, AZ, 85710, USA.,, Tucson, USA
| | - Jim Schwiegerling
- Department of Ophthalmology, University of Arizona- College of Medicine, 6422 E. Speedway Blvd. Suite 100, Tucson, AZ, 85710, USA.,Department of Aerospace and Mechanical, University of Arizona-College of Engineering, 1130 N. Mountain Ave, Tucson, AZ, 85721, USA
| | - Eniko T Enikov
- Department of Ophthalmology, University of Arizona-College of Optical Science, University of Arizona-College of Medicine, 1630 E. University Blvd, Tucson, AZ, 85719, USA
| |
Collapse
|
9
|
McCafferty S, Levine J, Schwiegerling J, Enikov ET. Goldmann applanation tonometry error relative to true intracameral intraocular pressure in vitro and in vivo. BMC Ophthalmol 2017; 17:215. [PMID: 29178849 PMCID: PMC5702103 DOI: 10.1186/s12886-017-0608-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 11/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Goldmann applanation tonometry (GAT) error relative to intracameral intraocular pressure (IOP) has not been examined comparatively in both human cadaver eyes and in live human eyes. Futhermore, correlations to biomechanical corneal properties and positional changes have not been examined directly to intracameral IOP and GAT IOP. METHODS Intracameral IOP was measured via pressure transducer on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically on each patient alternately to 10, 20, and 40 mmHg. IOP was measured using a Perkins tonometer in the supine position on 58 eyes and upright on a subset of 8 eyes. Twenty one (21) fresh human cadaver globes were Intracamerally IOP adjusted and measured via pressure transducer. Intracameral IOP ranged between 5 and 60 mmHg. IOP was measured in the upright position with a Goldmann Applanation Tonometer (GAT) and supine position with a Perkins tonometer. Central corneal thickness (CCT) was also measured. RESULTS The Goldmann-type tonometer error measured on live human eyes was 5.2 +/-1.6 mmHg lower than intracameral IOP in the upright position and 7.9 +/- 2.3 mmHg lower in the supine position (p < .05). CCT also indicated a sloped correlation to error (correlation coeff. = 0.18). Cadaver eye IOP measurements were 3.1+/-2.5 mmHg lower than intracameral IOP in the upright position and 5.4+/- 3.1 mmHg in the supine position (p < .05). CONCLUSION Goldmann IOP measures significantly lower than true intracameral IOP by approximately 3 mmHg in vitro and 5 mmHg in vivo. The Goldmann IOP error is increased an additional 2.8 mmHg lower in the supine position. CCT appears to significantly affect the error by up to 4 mmHg over the sample size.
Collapse
Affiliation(s)
- Sean McCafferty
- Intuor Technolgies, LLC, 6422 E. Speedway Blvd. Tucson, Suite 100, Tucson, AZ, 85710, USA. .,Department of Ophthalmology, University of Arizona College of Medicine, 655 n alvernon, Tucson, AZ, 85710, USA. .,University of Arizona College of Optical Science, 1630 E. University Blvd., Tucson, AZ, 85719, USA. .,Arizona Eye Consultants, 6422 E. Speedway Blvd. Tucson, Suite 100, Tucson, AZ, 85710, USA.
| | - Jason Levine
- Department of Ophthalmology, University of Arizona College of Medicine, 655 n alvernon, Tucson, AZ, 85710, USA.,Arizona Eye Consultants, 6422 E. Speedway Blvd. Tucson, Suite 100, Tucson, AZ, 85710, USA
| | - Jim Schwiegerling
- Department of Ophthalmology, University of Arizona College of Medicine, 655 n alvernon, Tucson, AZ, 85710, USA.,University of Arizona College of Optical Science, 1630 E. University Blvd., Tucson, AZ, 85719, USA
| | - Eniko T Enikov
- Department of Mechanical and Aerospace, University of Arizona College of Engineering, 1130 N. Mountain Ave., Tucson, AZ, 85721, USA
| |
Collapse
|
10
|
Abstract
PURPOSE To evaluate the ease of handling of two rebound tonometers, which are designed for self-measurement of intraocular pressure (IOP) in a clinical setting by untrained patients. METHODS After self-measurement of the IOP with the rebound tonometers iCare ONE and iCare HOME, participants were asked to complete a questionnaire containing different subitems concerning ease of operation using a visual analog scale (1 = very good to 5 = very poor). Moreover, the feasibility and duration of measurement were tested. RESULTS A total of 147 subjects participated in this study. The mean score for general handling ability was 2.79 ± 1.01 for the iCare ONE and 1.85 ± 0.87 for the iCare HOME (p < 0.001). The evaluation of the subitems sense of safety (iCare ONE: 2.71 ± 1.03 and iCare HOME: 1.87 ± 0.81, p < 0.001) and comfort of measurement (iCare ONE: 2.07 ± 1.01 and iCare HOME: 1.66 ± 0.72, p < 0.001) also showed a significant discrepancy between the two tonometers. Participants needed significantly less time for a single valid measurement when using the iCare HOME tonometer (mean 66.14 ± 61.54 s) compared to the iCare ONE tonometer (mean 81.54 ± 69.51 s, p < 0.001). CONCLUSIONS A better handling of the iCare HOME rebound tonometer in comparison to the iCare ONE tonometer can be deduced on the basis of the subjective assessments of patients and the shorter duration of measurements. Moreover, the iCare HOME received a significantly better evaluation for all subitems. The accuracy of measurements using the iCare HOME still needs to be clarified.
Collapse
Affiliation(s)
- N Mihailovic
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
| | - J Termühlen
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
| | - M Alnawaiseh
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
| | - N Eter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland
| | - T S Dietlein
- Zentrum für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland
| | - A Rosentreter
- Klinik für Augenheilkunde, Universitätsklinikum Münster, Münster, Deutschland.
- Klinik für Augenheilkunde, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
| |
Collapse
|
11
|
Koprowski R, Wilczyński S, Nowinska A, Lyssek-Boron A, Teper S, Wylegala E, Wróbel Z. Quantitative assessment of responses of the eyeball based on data from the Corvis tonometer. Comput Biol Med 2015; 58:91-100. [PMID: 25622180 DOI: 10.1016/j.compbiomed.2015.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/31/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND The "air-puff" tonometers, include the Corvis, are a type of device for measuring intraocular pressure and biomechanics parameters. The paper attempts to analyse this response and its relationship with other parameters measured in the Corvis tonometer. METHODS A number of 13,400 2D images were acquired from the Corvis device and analysed (32 healthy and 16 ill people). A new method has been proposed for the analysis of responses of the eyeball based on morphological transformations and contextual operations. RESULTS The proposed algorithm enables to determine responses of the eyeball to an air puff coming from the Corvis tonometer. Additionally, responses of the eyeball have been linked to some selected features of corneal deformation. The results include, among others: (1) distinguishability between the left and right eye with an error of 7%; (2) the correlation between the area under the curve in corneal deformation and the response of the eyeball -0.26; (3) the correlation between the highest concavity time and the maximum deformation amplitude of 0.4. All these features are obtained fully automatically and repetitively at a time of 3.8s per patient (Core i7 10GB RAM). DISCUSSION It is possible to measure additional parameters of the eye deformation which are not available in the original software of the Corvis tonometer. The use of the proposed methods of image analysis and processing provides results directly from the eye response measurement when measuring intraocular pressure.
Collapse
Affiliation(s)
- Robert Koprowski
- Department of Biomedical Computer Systems, University of Silesia, Faculty of Computer Science and Materials Science, Institute of Computer Science, ul. Będzińska 39, Sosnowiec 41-200, Poland.
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, School of Pharmacy, Medical University of Silesia in Katowice, ul, Kasztanowa 3, Sosnowiec 41-200, Poland
| | - Anna Nowinska
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Anita Lyssek-Boron
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Sławomir Teper
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Edward Wylegala
- Ophthalmology Clinic, Medical University of Silesia, District Railway Hospital in Katowice, Katowice, Poland
| | - Zygmunt Wróbel
- Department of Biomedical Computer Systems, University of Silesia, Faculty of Computer Science and Materials Science, Institute of Computer Science, ul. Będzińska 39, Sosnowiec 41-200, Poland
| |
Collapse
|
12
|
Ademola-Popoola DS, Odi AF, Akande TM. COMPARISON OF IOP READINGS USING REBOUND I CARE TONOMETER AND PERKINS APPLANATION TONOMETER IN AN AFRICAN POPULATION. J West Afr Coll Surg 2014; 4:17-30. [PMID: 26587515 PMCID: PMC4501181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Accurate intra ocular pressure (IOP) measurement and monitoring using tonometry is a common clinical measurement in diagnosis and management of glaucoma, this is often a challenge in children. The ICare and Perkins tonometers are both handheld tonometers, Perkins uses applanation while ICare measures IOP with a rebound method. OBJECTIVES The objectives of research were to study the IOP values from each tonometer, compare the value of IOP readings from both tonometers, determined the ease of their use in young children and document the various positions in which the tonometers were used successfully in children. METHOD Intra ocular pressure readings were taken by two experienced examiners in upright position without sedation or anaesthesia. ICare tonometer was first used. Data were entered and analysed with SPSS 17 statistical package. The means were compared using paired sample T-test. RESULTS A total of 480 eyes of 240 persons, aged between 2months and 90years with a mean of 46.2±22 years had their intra-ocular pressure range between 3 and 44mmHg( Mean16.3±6) measured using ICare and Perkins tonometry. There was a high correlation, and no statistically significant differences in the mean IOP comparing ICare and Perkins tonometers. The mean difference in average IOP readings between ICare and Perkins was -0.08±2.8 (95% CI: 0.45-0.30; r=0.87, p= 0.68) for right eye and -0.15±2.8mmHg (95% CI -0.53 to 0.23; r=0.86, p=0.44) in the left eye The difference in the average IOP reading from both tonometers was within 2mmHg 288(66.2%) eyes. Among the 147 (33.8%) eyes with a difference in IOP greater than 2mmHg, Perkins was responsible for the higher IOP reading in 76(51.7%) and ICare in 71(48.3%) p=0.56. Among 42 eyes of 21 children aged ≤6years, IOP reading was successfully taken in 41(97.6%) and 21(50%) eyes with ICare and Perkins respectively without sedation or anaesthesia. CONCLUSION The IOP readings using the ICare tonometer compares well with that of Perkins tonometer. The ICare was easier to use in young children (≤6year olds) without sedation or anaesthesia in this African population.
Collapse
Affiliation(s)
- D S Ademola-Popoola
- Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | |
Collapse
|