| 발표일자: |
2019년 11월 1일(금)~3(일) |
| 발표번호: |
P(e-poster)-398 |
| 발표장소: |
B3 Parking Area
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| The Pitfalls of Tonometry in Clinical Practice |
| Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan(1)
College of Medicine, National Yang Ming University, Taipei, Taiwan(2)
Institute of Public Health and Community Medicine, National Yang Ming University, Taipei, Taiwan(3)
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan(4) |
| Yachuan Hsiao(1,2)Ching-Yao Tsai(1,3); I-Lun Tsai(1); Lin-Chung Woung(1,4) |
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Purpose : A precise intraocular pressure (IOP) measurement is crucial for decision making in glaucoma diagnosis and treatment. Goldmann applanation tonometry (GAT) has become the gold standard for decades, but there are several pitfalls which produce significant error in IOP measurement. In clinical practice, various factors have significant influence on the accuracy of GAT, such as corneal astigmatism, corneal thickness, scleral rigidity, and interface of tonometer –tear film contact. The purpose is to compare the measurements of IOPs by Dynamic Contour Tonometry (DCT) and tonopen tonometry in eyes underwent penetrating keratoplasty (PK).
Methods : Thirty eyes of thirty patients after penetrating keratoplasty (PK) and ten eyes of ten control subjects without any ocular surgery received IOP measurements by DCT and tonopen.(mean age=67.6) Ocular pulse amplitude (OPA),indicating ocular blood flow, was recorded as the difference between maximum and minimum IOP. The agreements and difference between two methods was analyzed by Bland-Altman plots.
Results : Average of DCT IOP were 13.1±5.4 mmHg and tonopen IOP were 14.9±5.3 mmHg in corneal transplant group, and 11.2±2.7 mmHg, 11.9±3.2 mmHg in control group, respectively. Approximately half of the differences of IOPs were within 2 mmHg between two methods. Tonopen measurements were higher than DCT measurements in 78%. The mean ocular pulse amplitude(OPA) in corneal transplant group and control group were 1.8±0.9 and 1.6±0.8 mmHg,
Conclusion : We found a good agreement between IOP measurements by tonopen and dynamic contour tonometer. Based on the principle of contour matching rather than applanation, DCT measurement eliminates influence of corneal thickness, rigidity, curvature, and elastic properties.The results indicated the possibility and application of DCT in patients underwent corneal transplant. DCT had limitations in clinical practice and patient’s cooperation was required in this method. Ophthamologists should be able to keep in mind these potential pitfalls of different tonometers in IOP measurement in special conditions.
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