Comparison of Intraocular Pressure Measurement by Goldmann Applanation Tonometry and Pneumotonometry in Healthy Subjects and Patients with Primary Open Angle Glaucoma
Abstract
ABSTRACT:
Objective:To evaluate the role of non-contact Pneumo-tonometry (PT) by comparing intraocular pressure (IOP) measurements
with Goldmann Applanation Tonometry (GAT) and PT in healthy subjects, and patients with Primary Open Angle Glaucoma
(POAG).
Materials and Methods: This prospective comparative study was conducted at PNS Shifa Naval Hospital, Karachi from January
2016 to June 2016. A total of 360 eyes of 180 patients were included, and IOP measurement was done using GAT and PT
methods. The difference in readings between the two methods was calculated and analysed using SPSS version 17.
Results: A total of 360 eyes were analysed. 90 healthy subjects (180 eyes) and 90 patients with diagnosed POAG (180 eyes)
were included. Mean IOP measured in all eyes using GAT and PT was 16.32±5.31 mm of Hg and 18.16±6.76 mm of Hg
respectively. Mean difference in IOP was 2.31±1.89 mmHg between two methods, with 278(77.22%) eyes showing higher IOP
reading than those measured using GAT. The difference of readings between two methods was statistically significant. The
patients with POAG were divided into three groups. Group 1 had IOP less than 15 mm Hg, Group 2 had IOP between 15-25
mm Hg and Group 3 had IOP greater than 25 mm Hg. Mean difference in IOP between two methods was 1.38±1.85, 2.29±2.72
and 3.05±2.68 mm Hg in Group 1,2 and 3 respectively. The mean difference of IOP measurement using GAT and PT in these
groups was statistically significant (P<0.001)
Conclusion: IOP measurement using PT overestimates the recorded IOP as compared to GAT, and the difference is more
pronounced in eyes with higher than normal IOP.
References
Chihara E. Assessment of true intraocular pressure: the gap between theory and practical data. Survey of ophtha-lmology 2008;53(3):203-18.
Nebbioso M, Fazio S, Di Blasio D, Pescosolido N. Hyp-obaric hypoxia: effects on intraocular pressure and corn-eal thickness. The Scientific World Journal 2014;43(2): 202-15.
Fernandes P, Díaz-Rey JA, Queirós A, Gonzalez-Meijo-me JM, Jorge J. Comparison of the ICare rebound tono-meter with the Goldmann tonometer in a normal popula-tion. Ophthalmic Physiol Opt 2005;25:436-40.
Quigley HA. Number of people with glaucoma world-wide. Br J Ophthalmol1996;80:389-93.
Kyari F, Abdull MM, Bastawrous A, Gilbert CE, Faal H. Epidemiology of glaucoma in sub-saharan Africa: prevalence, incidence and risk factors. Middle East Afr J Ophthalmol 2013;20:111-25.
Bettin P, Di Matteo F. Glaucoma: present challenges and future trends.Ophthalmic Res 2013;50:197-208.
Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajase-garam R, Pokharel GP et al. Global data on visual impa-irment in the year 2002. Bulletin of the world health organization. 2004;82(11):844-51.
Morrison JC, Pollack IP, editors. Glaucoma Science and Practice. New York, NY: Thieme Medical Publishers; 2003.p.60-4.
Kniestedt C, Punjabi O, Lin S, Stamper RL. Tonometry through ages. Surv Ophthalmol 2008; 53:568-91.
Goldmann H, Schmidt T. Über Applanations tonome-trie. Ophthalmologica 1957;134:221-42.
Almubrad TM, Ogbuehi KC. The effect of repeated applanation on subsequent IOP measurements. Clin Exp Optom 2008; 91: 524-9.
Farhood QK. Comparative evaluation of intraocular pressure with an air-puff tonometer versus a Goldmann applanation tonometer. Clin Ophthalmol 2013;7:23-7.
Firat PG, Cankaya C, Doganay S. The influence of soft contact lenses on the intraocular pressure measurement. Eye (Lond) 2012; 26:278–82.
Martinez-de-la-Casa JM, Jimenez-Santos M, Saenz-Frances F. Performance of the rebound, non contact and Goldmann applana¬tion tonometers in routine clinical
practice. Acta Ophthalmol 2011;89:676-80.
Tonnu PA, Ho T, Sharma K, White E, Bunce C, Garway-Heath D. A comparison of four methods of tonometry: method agreement and inter observer variability. Br J Ophthalmol 2005;89:847-50.
Lagerlöf O. Airpuff tonometry versus applanation tono-metry. Acta Ophthalmol (Copenh) 1990;68:221-4.
Rao BS. Clinical evaluation of the non-contact tonometer and com¬parison with Goldmann applanation tonometer. Indian J Ophthalmol 1984;32:432-4.
AlMubrad TM, Ogbuehi KC. The effect of repeated applanation on subsequent IOP measurements. ClinExp Optom 2008;91:524-9.
Regine F, Scuderi GL, Cesareo M, Ricci F, Cedrone C, Nucci C. Validity and limitations of the Nidek NT-4000 non-contact tonometer: a clinical study. Ophthalmic Physiol Opt 2006;26:33-9.
Shimmyo M, Ross A J, Moy A, Mostafavi R. Intraocular pressure, Goldmann applanation tension, corneal thick-ness, and corneal curvature in Caucasians, Asians, Hisp-anics, and African Americans. Am J Ophthalmol 2003; 136:603-13.
Holladay JT, Allison ME, Prager TC. Goldmann applana-tion tonometry in patients with regular corneal astigma-tism. Am J Ophthalmol 1983;96:90-3.
Motolko M.A, Feldman F, Hyde M, Hudy D. Sources of variability in the results of applanation tonometry. Can J Ophthalmol 1982;17:93-5.
Foster PJ, Broadway DC, Garway-Heath DF, Yip JL, Luben R, Hayat S et al. Intraocular pressure and corneal biomechanics in an adult British population: the EPIC-Norfolk eye study. Investigative ophthalmology & visual science 2011;52(11):8179-85.
Chakraborty R, Read SA, Collins MJ. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci2011;11: 5121-9.
Tonnu PA, Ho T, Newson T, El Sheikh A, Sharma K, White E et al. The influence of central corneal thickness and age on intraocular pressure measured by pneumoto-nometry, non-contact tonometry, the Tono-Pen XL and Goldmann applanation tonometry. British Journal of Ophthalmology 2005;89(7):851-4
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