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Caterina M. Schweier, Marc Toeteberg-Harms, Jens Funk; Repeatability of Intraocular Pressure Measurements in Sitting and Supine Position with Icare Pro™. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5075.
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Icare Pro is a new Rebound tonometer which is able to measure intraocular pressure (IOP) in both, sitting and supine position. In this study we compared this device with the hand-held (hh) tonometer (Tonopen) and the Goldmann tonometer (GAT) as gold standard. Repeatability in healthy individuals in sitting and supine position was calculated.
IOP was measured twice consecutively with Icare Pro, Tonopen and Goldmann tonometer in a randomized order by one single operator. IOP was measured first in sitting position. Test persons then lied down for 10 min. IOP was measured again twice with both hh-devices in supine position.
36 eyes of 36 volunteers were included. Mean age was 41.9±13.8 years. Mean IOP measured by GAT (sitting) was 14.9±3.5mmHg. Mean IOP measured by Tonopen was 14.8±2.7mmHg in sitting and 17.0±3.0mmHg in supine position, respectively. Mean IOP measured by Icare Pro was 15.6±3.1mmHg in sitting and 16.5±3.5mmHg in supine position, respectively. Compared to GAT there was a ΔIOP of 0.1 (Tonopen, sitting, P=0.954), -0.7 (Icare Pro, sitting, P=0.060), -2.2 (Tonopen, supine, P<0.001) and -1.6mmHg (Icare Pro, supine, P<0.001). ΔIOP(sitting-supine) was -2.2 (P<0.001) for Tonopen and -0.9mmHg P=0.020) for Icare Pro in supine position. Coefficients of variation (COV) were 2.9% for GAT and for the Tonopen 4.8% in sitting and 3.7% in supine position, respectively, and for the Icare Pro 5.6% in sitting and 6.9% in supine position, respectively. Power calculation revealed a power of ≥80% with a sample size of 36 eyes to detect a difference of 0.750mmHg with an alpha error and investigated standard deviations.
Our results show that IOP is higher in supine compared to sitting position (2.2mmHg for Tonopen and 0.9 for Icare). This is important because in some patients the use of a slit lamp mounted tonometer is impossible and IOP must be measured in supine position. In those cases, the higher reading of IOP in supine position must be taken into account. There was significant difference between IOP measurements by GAT and both hh-devices only in supine but not in sitting position. COVs were pleasant and very similar for GAT and both hh-devices regardless of position.
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