Abstract
Purpose :
Although Goldmann applanation tonometry (GAT) remains the gold standard for intraocular pressure (IOP), alterations in corneal parameters can impact the accuracy of GAT-IOP. We aim to compare IOP measurements across GAT, iCare Rebound Tonometry (RT), Tono-Pen XL (TXL), and Ocular Response Analyzer (ORA) in patients with corneal edema due to Fuchs’ endothelial corneal dystrophy (FECD).
Methods :
A prospective, comparative study was performed on patients with FECD. The study population consisted of patients from Rush University Eye Center Physicians and University Ophthalmology Associates. Central corneal thickness (CCT) via ultrasound pachymetry and IOP across GAT, RT, TXL, and ORA were obtained from 10 eyes of 10 patients. Corneal compensated IOP (IOPcc) and Goldmann-correlated IOP (IOPg) were measured via ORA. Corneal edema was diagnosed based on slit lamp examination. Exclusion criteria were patients younger than 18 years of age, history of glaucoma, ocular hypertension, use of antiglaucoma medication, keratoplasty, refractive surgery, contact lens wearer, and inability to complete testing.
Results :
Mean GAT-IOP was 12.4 ± 2.8 mm Hg (range, 8-17) and mean CCT was 600.8 ± 67.2 µm (range, 514-695). Mean RT-IOP was 10.2 ± 2.4 mm Hg (range, 4.7-13.3), which was statistically lower than GAT-IOP (p = 0.015). Mean TXL-IOP was 14.1 ± 3.6 mm Hg (range, 7.3-19.7), which was not statistically different from GAT-IOP (p = 0.105). Mean IOPcc was 16.5 ± 3.5 mm Hg (range, 11.5-22.4), which was statistically higher than GAT-IOP (p = 0.001). Mean IOPg was 13.9 ± 4.1 mm Hg (range, 3.7-18.8), which was not statistically different from GAT-IOP (p = 0.170).
Conclusions :
FECD may lead to either an underestimation or overestimation error of IOP based on different pressure modalities. RT-IOP was significantly lower than GAT-IOP, while IOPcc was significantly higher than GAT-IOP. There were no significant differences in IOP between GAT versus TXL and GAT versus IOPg, respectively. These findings may be useful in understanding which tonometer would give the most accurate IOP in a patient with FECD who requires treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.