Ophthalmology in China

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Comparison of five devices to measure intraocular pressure and analysis correlation with corneal biomechanical properties

Hu Die, Zhou Longfang, Peng Yusu, Lan Jie, Ge Qingshu, Xie Pingzhong, Xie Lixin, Pan Xiaojing   

  1. Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University-Shandong Academy of Medical Sciences, Qingdao 266071, China
  • Received:2020-04-12 Online:2020-09-25 Published:2020-09-25
  • Contact: Pan Xiaojing, Email: panxjcrystal36@163.com
  • Supported by:
    Shandong Science and Technology Agency Project(2018GSF118103); Shandong Academy of Medical Sciences Academy-Level Science and Technology Program Project (2017-18);Qingdao Science and Technology Benefiting People Demonstration Guide Project(20-3-4-39-nsh)

Abstract: Objective To compare consistency of five methods of tomometry in normal subjects: non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), Icare pro rebound tonometer (RBT), Tono-pen AVIA tonometer (TPT) and corneal visualization scheimpflug technology (CST), and to analyze the correlation between intraocular pressure (IOP) and corneal biomechanical properties. Design Diagnostic methods evaluation. Participants 44 healthy volunteers. Method All volunteers were measured IOP with five tomomers by one same doctor at the same time. Central cornea thickness(CCT) and cornea first applanation time (Time A1) were measured by CST. The IOP difference was measured by one way ANOVA and paired t test. Consistency test were measured with Bland-Altman test. The correlation between IOP and the CCT or Time A1 was analyzed with Pearson test. Main Outcome Measures IOP, average value of IOP differences, correlation coefficient. Results The mean IOP with the GAT, NCT, RBT, TPT, CST was 15.9±3.3 mmHg, 14.8±2.9 mmHg, 16.9±3.3 mmHg, 14.7±2.5 mmHg, and 16.1±3.0 mmHg, respectively. There was a statistically significant difference between NCT and GTA, TPT and GAT (P=0.01, 0.00). There was no statistically significant difference between RBT and GAT, CST and GAT(all P>0.05). Greater NCT, TPT, RBT and CST were significantly associated with greater GAT(r=0.63, 0.37, 0.63, 0.55; all P<0.05). Bland-Altman analysis showed that between NCT and GAT the 95% limits of agreement(95% LoA)were (-6.4, 4.2) mmHg, the mean difference were -1.1 mmHg; that between TPT and GAT the 95% LoA were (-6.3, 3.9) mmHg, the mean difference were -1.2 mmHg; that between RBT and GAT, the 95% LoA were (-6.2, 8.3) mmHg, the mean difference were 1.0 mmHg; that between CST and GAT, the 95% LoA were (-5.6, 6.2) mmHg, the mean difference were 0.3 mmHg. The mean CCT was 550.5±29.2 μm. The mean time A1 was 7.63±0.36 ms. Greater TPT significantly associated with greater CCT (r=0.40, P=0.01). Greater GAT, NCT, RBT, TPT and CST significantly associated with greater TIME A1 (r=0.53, 0.64, 0.55, 0.46, 0.99; all P<0.05). Conclusions RBT and CST have no significant difference with GAT. NCT and TPT are slightly lower than GAT. CST has the best consistency with GAT. TIME A1 is an important factor that affects intraocular pressure measurement. Greater TIME A1 associates with greater intraocular pressure value. (Ophthalmol CHN, 2020, 29: 365-369)

Key words: intraocular pressure, tonometer, corneal biomechanics