Purchase this article with an account.
Romina Baldivieso, María Luisa Zavala, Tania Moron Vidal, Gabriel S Lazcano, Jesus Jiménez-Roman; Comparison between Goldman, Icare and Tonopen tonometry in healthy and glaucomatous pediatric patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6435.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The diagnosis and follow up of glaucoma in pediatric patients are often complicated, due to inadequate tonometry and exploration. It is important to have a reliable and easy method of tonometry for children, for accurate diagnosis, follow up and treatment. The purpose of the study is to compare Goldman tonometry, which is currently the gold standard, however there is poor cooperation from patients with this method, versus tonopen and Icare, taking into account the influence of central corneal thickness (CCT).
A comparative, transversal, observational study was done, comparing the intraocular pressure (IOP) with these 3 tonometry methods, in healthy and glaucomatous patients between 2 - 12 years old. Corneal curvatures were measure with autorefractometer, the CCT with ultrasonic pachymeter and axial length (AL) with ultrasound. Parents signed the informed consent.
We analyzed 19 eyes. The mean age was 6.58 years. 12 were male and 7 female. 16 had congenital glaucoma and 3 were healthy. The mean CCT was 603.15 microns (um) and the AL was 24.32 um. The mean CCT in healthy patients was 574 um and 764.87 um in glaucomatous patients. The mean AL was 22.36 mm in healthy patients and 30.85 mm in glaucomatous patients. The mean IOP in mmHg was 16.25 for Icare, 21.94 for Tonopen and 14.68 for Goldman. In healthy patients, the mean IOP was 14.33, 17.33 and 12.00 mmHg with Icare, Tonopen and Goldman respectively compared with 20.87, 24.75 and 19.12 respectively in glaucomatous patients. There was no correlation between CCT and AL with none of the tonometers evaluated. Pain was evaluated according to visual analog pain scale, in which 0 means no pain and 10 is the maximum pain. The values obtained were 0.53 for Icare, 3.58 for Tonopen and 1.58 for Goldman.It is confirmed that the IOP values obtained with Icare and Tonopen are higher than those obtained with Goldman. The differences between Icare and Goldman was 1.58 mmHg, however the highest difference was 7.26 mmHg found between Tonopen and Goldman.
We conclude that Icare tonometry is an effective method compared with Goldman, is the most comfortable of the 3 methods in this age group and can be safely used to monitor the intraocular pressure in children. The Tonopen was the least comfortable method, and measured the highest values of IOP.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only