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. 2014 Jan;39(1):11-9.

Intraocular Pressure Measurements by Three Different Tonometers in Children with Aphakic Glaucoma and a Thick Cornea

Mohammad Reza Razeghinejad  1 , Ramin Salouti  1 , Mohammad Reza Khalili  1
Affiliations

Intraocular Pressure Measurements by Three Different Tonometers in Children with Aphakic Glaucoma and a Thick Cornea

Mohammad Reza Razeghinejad et al. Iran J Med Sci. 2014 Jan.

Abstract

Background: To evaluate the agreement in intraocular pressure (IOP) measurements by Ocular Response Analyzer (ORA) and Tono-Pen XL (TXL) with the Goldmann Applanation Tonometer (GAT) and to examine corneal biomechanical properties in aphakic glaucoma patients with a central corneal thickness (CCT) >600 µ.

Methods: Thirty-six eyes of aphakic glaucoma patients (group 1) and 40 eyes of normal children (group 2) were studied. The mean ORA and TXL IOP values were compared with the GAT-IOP values. Regression analyses were used to evaluate the associations between IOP and CCT, corneal hysteresis (CH), and corneal resistance factor (CRF). Bland-Altman plots were used to evaluate the agreement between the tonometers.

Results: The mean±standard deviations of the age and male/female ratio were 16.58±5.44 and 15.75±5.04 years and 14/22 and 18/22 in group 1 and group 2, respectively. CCT in group 1 was 651.1±42 and in group 2 was 567.3±32.4. In group 1, the mean TXL (22.4, P=0.004), IOPcc (corneal compensated) (27.8, P=0.005), and IOPg (Goldmann correlated) values (28.1, P<0.0001) were greater than GAT-IOP (20.6). In group 2, only IOPg value (16.4) was higher than GAT-IOP (14.8, P=0.04). IOP reading of all the tonometers were positively and negatively associated with CRF and CH in the multiple regression analysis, respectively.

Conclusion: The TXL had a greater agreement with the GAT, and the ORA overestimated IOP in aphakic glaucoma patients. The ORA and TXL seemed to be affected by CH and CRF.

Keywords: Aphakia; Cornea; Intraocular pressure; Tonometry.

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Figures

Figure 1
Figure 1
Box-and-Whisker plots, showing mean intraocular pressure (IOP) values obtained by the Goldmann Applanation Tonometer (GAT), Ocular Response Analyzer (ORA), and Tono-Pen XL in groups 1 and 2. IOPcc: Corneal-compensated IOP; IOPg: Goldmann-correlated IOP
Figure 2
Figure 2
Bland-Altman analysis of intraocular pressure (IOP) measured by the Ocular Response Analyzer (ORA) (IOPcc, IOPg), Tono-Pen XL, and Goldmann Applanation Tonometer (GAT) in group 1. IOPcc: Corneal-compensated IOP; IOPg: Goldmann-correlated IOP; SD: Standard deviation
Figure 3
Figure 3
Bland-Altman analysis of intraocular pressure (IOP) measured by the Ocular Response Analyzer (IOPcc, IOPg), Tono-Pen XL, and Goldmann Applanation Tonometer (GAT) in group 2. IOPcc: Corneal-compensated IOP; IOPg: Goldmann-correlated IOP; SD: Standard deviation
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