July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
24-hour intraocular pressure (IOP) monitoring with Goldmann applanation (GAT) tonometry and Tono-Pen AVIA® in keratoconic eyes.
Author Affiliations & Notes
  • Rafael Vidal Merula
    Visual Sciences Laboratory, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  • Sebastiao Cronemberger
    Visual Sciences Laboratory, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  • Artur C Veloso
    Visual Sciences Laboratory, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  • Alberto Diniz-Filho
    Visual Sciences Laboratory, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
  • Footnotes
    Commercial Relationships   Rafael Merula, None; Sebastiao Cronemberger, None; Artur Veloso, None; Alberto Diniz-Filho, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2691. doi:
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      Rafael Vidal Merula, Sebastiao Cronemberger, Artur C Veloso, Alberto Diniz-Filho; 24-hour intraocular pressure (IOP) monitoring with Goldmann applanation (GAT) tonometry and Tono-Pen AVIA® in keratoconic eyes.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2691.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The adequate IOP evaluation in keratoconic eyes remains a challenge. This study aims to compare IOP measurements obtained by GAT and Tono-Pen AVIA® during daily curve of IOP (DCPo) and to assess relationship between IOP values and Pentacam parameters in keratoconic corneas.

Methods : Keratoconic patients attended at the São Geraldo Hospital were included. All participants underwent a detailed ophthalmologic examination. The diagnosis of keratoconus was made on the basis of the following diagnostic criteria (1 sign or a combination of signs): Munson’s sign (V-shaped conformation of the lower lid on down gaze); biomicroscopic signs: stromal thinning, conical protrusion, Fleischer ring, Vogt striae, and enlarged corneal nerves; and an abnormal retinoscopy reflex. The diagnosis was confirmed topographically with the Oculus Pentacam system (TKC ‘‘Topographical Keratoconus Classification’’). We excluded keratoconic eyes with acute corneal hydrops, corneal scarring, penetrating or lamellar keratoplasty, keratitis. Each DCPo consisted of 5 IOP measurements performed with GAT and Tono-Pen AVIA® at 9:00 am, 11:00 am, 6:00 pm and 10:00 pm and in the morning of the following day at 6:00 am with Perkins tonometer with the patient in a supine position in bed and in darkness and before he had stood up. Because of corneal astigmatism, the GAT prism red line was placed at the prism degree mark corresponding to the flattest meridian (minus cylinder) to correct IOP measurement (GATc); also, measurements without these corrections were done. IOP measurements were performed by two doctors (SC and AV). The average IOP and the standard deviation (variability -V) were calculated for both GAT and Tono-Pen AVIA®.

Results : Eighteen patients (29 eyes), mean age of 24.9±9.1 years, 5 males and 13 females, 3 white, 12 mixed and 3 black were included. The mean Pentacam findings were: k average: 50.1±5.5D; k maximum: 57.3±7.1D; Qvalue: -0.81±0.4; astigmatism: 4.1±1.9; Badd: 8.9±5.7; thinnest point: 446±66; pachyprogindex: 2.4±1.6; pachyapex: 460±63; volume 57.2±4.3. The mean IOP and V were respectivelly: 11.5 mmHg and 2.77 (GATc); 10.3 mmHg and 2.51 (uncorrected GAT) and 13.3 mmHg and 2.15 (Tono-Pen AVIA®).

Conclusions : It was observed difference particularly between uncorrected astigmatism GAT measurement and Tono-Pen AVIA® during 24-hour IOP monitoring in keratoconic eyes.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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