J Korean Ophthalmol Soc.  2012 Jul;53(7):988-995. 10.3341/jkos.2012.53.7.988.

Comparison of Rebound Tonometer, Non-Contact Tonometer, Goldmann Applanation Tonometer and the Relationship to Central Corneal Thickness

• Lee J
• Seong M
• Kang M
• Cho H
• Lee Y

• KMID: 2215858
• DOI: http://doi.org/10.3341/jkos.2012.53.7.988

Abstract

PURPOSE
To compare the level of accuracy of intraocular pressure (IOP) measurements of a rebound tonometer (RT) Icare(R), and non-contact tonometer (NCT), using Goldmann Applanation tonometer (GAT) as a reference to evaluate the influence of central corneal thickness (CCT) on IOP readings in the Korean population.
METHODS
In a prospective study of 273 eyes, IOP was measured with RT, GAT, and NCT and compared to CCT measurements. Patients were assigned to one of 3 groups based on IOP measurements of GAT and 1 of 2 groups based on CCT. The comparison of the IOP values of RT, GAT, and NCT was performed between the IOP and CCT groups, and the differences among tonometers were evaluated.
RESULTS
The RT showed statistically significant correlation with the GAT compared to the NCT. The CCT was related to RT measurements. The RT values compared to the GAT was underestimated in thin corneas and overestimated in thick corneas.
CONCLUSIONS
There was a significant correlation between the RT and the GAT measurements compared with the NCT. However, RT is influenced by CCT and correlates less with GAT in low IOP ranges, suggesting that corneal thickness should be taken into consideration during such measurements.

Keyword

Central corneal thickness; Goldmann applanation tonometer; Non-contact tonometer; Rebound tonometer

MeSH Terms

Cornea
Eye
Humans
Intraocular Pressure
Peptides
Prospective Studies
Reading
Peptides

Figure

• 

  Figure 1 The correlation between Goldmann applanation tonometer and rebound tonometer IOP measurements (r = 0.913, p < 0.001).

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  Figure 2 Bland-Altman plots of agreement between Goldmann applanation tonometer and rebound tonometer for each eye measured (A), and Goldmann applanation tonometer and Non-contact tonometer (B). The differences in IOP of both tonometers (Goldmann applanation tonometer value minus rebound tonometer value (or non-contact tonometer value), mmHg) is plotted against the average of the IOP of both tonometers. The solid line is the mean of the average IOP values of both tonometers. The dotted horizontal lines are ±1.96 SD confidence interval (CI) (i.e. 95% of the points should fall within these lines).

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  Figure 3 Frequency distribution of differences between rebound tonometer, Goldmann applanation tonometer, and noncontact tonometer measurements.

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  Figure 4 Scatterplots showing the relationship between central corneal thickness and IOP value of Goldmann applanation tonometer (R2 = 0.057, p < 0.001) (A), IOP values of rebound tonometer (R2 = 0.104, p < 0.001) (B).

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