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Patricia Toro, Carmen Dora Mendez-Hernandez, Ana Fernandez-Vidal, Raquel Martinez-Chico, Silvia Perez-Trigo, Federico Saenz-Frances, David Diaz-Valle, Jose Maria Martinez-de-la-Casa, Enrique Santos, Julian Garcia-Feijoo; Comparison Of Intraocular Pressure Measurement Using Goldmann, Iopen And Icare Tonometers In Patients With Penetrating Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5087. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare Rebound, iCare and Iopen intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT) in post-keratoplasty corneas, and to assess the influence of central corneal thickness (CCT), corneal curvature (CC), astigmatism, and time after PKP on IOP measurement.
This cross-sectional study included one eye of 53 post-penetrating keratoplasty (PK) patients. All subjects underwent GAT, iCare and Iopen IOP measurements in random order, and CCT, CC and astigmatism evaluation. The Bland-Altman method and multivariate regression analysis were used to assess inter-tonometer agreement and the influence of CCT, CC and astigmatism on IOP.
iCare underestimated IOP compared with GAT (GAT minus iCare 1.93±7.03mmHg, (95% C.I. -0.86-3.96)). Iopen significantly underestimated IOP compared with GAT (GAT minus Iopen 3.59 ±9.08 mmHg (95% C.I. 0.98 - 6.19)). There was no significant relation between IOP and CCT, CC, astigmatism, or time after PKP. In 49 of 52 of the patients IOP measurements with GAT were reliable. There were no difficulties in obtaining measurements with either iCare or Iopen tonometries.
Agreement between GAT and iCare was clinically optimal. No agreement was found between GAT and Iopen. GAT, iCare and Iopen measurements were not affected by CCT, CC, astigmatism, or time after PKP. iCare may be closer to providing a real IOP post-PK, and may be an alternative when GAT is not possible. However, Iopen measurements have to be taken cautiously bearing in mind the difference obtained with both methods.
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