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Andrea M. Schild, Manuel M. Hermann, Julia Fricke, Antje Neugebauer, Michael Diestelhorst; The Effect Of General Anesthesia On Rebound Tonometry Measurements In Normal Eyes Of Preschool Children. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6778.
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© ARVO (1962-2015); The Authors (2016-present)
To study the influence of general anesthesia on intraocular pressure (IOP) - rebound tonometry (RT) measurements - in healthy eyes of preschool children undergoing strabismus surgery.
90 eyes of 45 healthy children (28 boys, 17 girls) with strabismus, aged 4 to 7 years (mean age: 5.3 ± 0.8 years) were included in this prospective study. Intraocular pressure (IOP) was assessed by repeated RT measurements (iCare®, Tiolat Oy, Helsinki, Finland) in the awake and sitting child on the preoperative day. IOP was measured again using RT in supine position ten to fifteen minutes after anesthetization before subsequent strabismus surgery. The mean of three single RT IOP measurements was used for further analysis. IOP data obtained before and under general anesthesia was compared using non-parametric testing for paired samples (Wilcoxon). Written informed consent was obtained from all parents. This study was approved by the ethics committee of the Cologne University and driven in accordance to the Declaration of Helsinki.
For right eyes (OD), mean IOP before anesthesia was 16.6 ± 4.7 mmHg (range 9 - 32 mmHg), and during anesthesia 12.4 ± 3.4 mmHg (range 5-19 mmHg). For left eyes (OS), mean IOP before anesthesia was 16.3 ±3.9 mmHg (range 8 - 25 mmHg, during anesthesia 12.6 ±3.8 mmHg (range 7 - 23 mmHg). Mean IOP measurements in awake children were significantly higher when compared to data obtained during anesthesia with a mean difference of minus 4.2 ± 4.9 mmHg (minus 19 - 8 mmHg) for OD and minus 3.7 ± 4.7 mmHg (minus 12 - 9 mmHg) for OS, respectively. The differences were statistically highly significant for OS and OD (Wilcoxon, p<0.0001). In 36 OD and 38 OS IOP during anesthesia was lower or the same compared to IOP before anesthesia. In 9 OS and 7 OD IOP during anesthesia was higher.
IOP of healthy preschool children measured by RT in sitting position differs significantly from IOP measured under anesthesia in supine position, with lower IOP values during anesthesia in most cases.
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