Comparability of icare pro rebound tonometer with goldmann applanation and noncontact tonometer in a

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Original Paper Ophthalmic Res 2015;54:18–25 DOI: 10.1159/000381781

Received: December 10, 2014 Accepted after revision: March 17, 2015 Published online: May 28, 2015

Comparability of Icare Pro Rebound Tonometer with Goldmann Applanation and Noncontact Tonometer in a Wide Range of Intraocular Pressure and Central Corneal Thickness Nevbahar Tamçelik a Eray Atalay b Erdogan Cicik a Ahmet Özkök a Cerrahpasa Medical School, Istanbul University, and b Istanbul Medipol University, Istanbul, Turkey

Key Words Corneal thickness · Goldmann applanation tonometer · Icare rebound tonometer

Abstract Purpose: To evaluate the agreement between the reading values of the Goldmann applanation tonometer (GAT), Icare Pro rebound tonometer (IRT) and noncontact tonometer (NCT) in glaucoma patients. Methods: This cross-sectional study comprised 292 eyes of 292 patients selected from a glaucoma outpatient clinic. The intraocular pressure (IOP) was measured sequentially, at a 10-min interval each, in the following order: NCT, IRT and GAT. The central corneal thickness (CCT) was measured using Pentacam HR before the IOP measurements. Results: The mean IOPs measured by the GAT, NCT and IRT were 20.17 ± 6.73 mm Hg (range: 4–48), 19.77 ± 6.88 mm Hg (range: 3–46) and 19.30 ± 5.15 mm Hg (range: 7.30–44.5), respectively. The correlation coefficients of the GAT and IRT, NCT and IRT, and GAT and NCT measurements were r2 = 0.673, r2 = 0.663 and r2 = 0.938 (all p < 0.001), respectively. The IRT tends to overestimate in the low GATmeasured IOPs, whereas it underestimates in high GAT-measured IOPs. The measurements of all 3 devices were also correlated with the CCT at a statistically significant level (GAT:

© 2015 S. Karger AG, Basel 0030–3747/15/0541–0018$39.50/0 E-Mail karger@karger.com www.karger.com/ore

r2 = 0.063, NCT: r2 = 0.063, IRT: r2 = 0.058). Conclusion: The agreement between the IRT and GAT measurements is higher in the IOP range of 9–22 mm Hg, whereas significant discrepancies occur as the IOP deviates from normal values. The variability of the IRT and GAT measurements over a wide range of CCT is minimal. © 2015 S. Karger AG, Basel

Introduction

The measurement of intraocular pressure (IOP) is of paramount importance in managing glaucoma patients, as the reduction of the IOP is the only proven method of slowing down glaucomatous disease progression [1]. Many new diagnostic devices have emerged recently, to aid in a faster and reasonably more comfortable measurement of the IOP, yet the Goldmann applanation tonometer (GAT) is still considered the gold standard. Among the alternatives, the ICare rebound tonometer (IRT) has gained much attention owing to its accuracy and reliability comparable to that of the GAT, noncontact tonometer (NCT) and Tono-Pen [2–4]. The IRT device uses the impact rebound principle to measure the IOP. It is composed of a probe in a solenoid housing which is fired by a Nevbahar Tamçelik Tesvikiye Mah. Hakki Yeten Cd. Terrace Fulya Center 2 D: 13 Sisli TR–34098 Istanbul (Turkey) E-Mail nevbahartamcelik @ gmail.com

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