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Tomomi Nakamura, Yoshiaki Kiuchi, Yosuke Sugimoto; Comparison of the Intraocular Pressure of Infants Obtained Using Three Portable Tonometers. Invest. Ophthalmol. Vis. Sci. 2014;55(13):130.
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The aim of the study was to investigate the agreement among portable tonometers; the iCare, iCare PRO and the Tonopen AVIA. We also examined the impact of the central corneal thickness on the intraocular pressure (IOP) readings.
IOP measurements were taken from the both eyes of 16 infants. The subject’s ages ranged from 33 pregnant weeks and corrected 83 pregnant weeks. The IOP values were measured without using an eye lid opener during a quiet stage. When the baby cried, we waited until the baby settled down. Tonometry using the iCare was performed while the infant’s face was turned sideways. The iCare PRO and Tonopen AVIA were used with the infant in the supine position. The central corneal thickness was measured by an ultrasound pachymeter. The relationships among the mean IOPs were evaluated using Pearson correlation coefficients, and the mean differences between tonometers were examined using a one-way analysis of variance followed by a Tukey-Kramer post-hoc analysis. The levels of agreement were evaluated using a Bland-Altman analysis.
The mean IOPs (mean ± SD) were 9.32 ± 2.33mmHg for the iCare; 14.8 ± 3.4mmHg for the iCare PRO and 17.6 ± 6.80 mmHg for the Tonopen AVIA. Moderate correlations were observed between the iCare and Tonopen AVIA (r=0.546), and between the iCare PRO and Tonopen AVIA (r=0.452). A low correlation was observed between the iCare and iCare PRO (r=0.360). The Bland-Altman analysis revealed that the mean difference between the iCare and iCare PRO was 3.51 mmHg (p < 0.001). The post-hoc analysis indicated that there were significant differences between all pairs. The IOP readings obtained by the iCare and iCare PRO were unaffected by the central corneal thickness. There was a negative correlation between the central corneal thickness and the infants’ corrected age (p < 0.05).
The IOP measurements obtained in infants using three portable tonometers were not interchangeable. The iCare PRO and Tonopen AVIA significantly overestimated the IOP values in the infants’ eyes compared with the iCare.
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