中央角膜厚度对Goldmann眼压计与非接触式眼压计测量值的影响

目的探讨中央角膜厚度（CCT）对Goldmann眼压计与非接触式眼压计（NCT）眼压测量值的影响。方法分别用Goldmann眼压计与NCT测量83例（83只眼）正常人的眼压,采用光学相干断层扫描仪（OCT）测量CCT。采用配对T检验比较Goldmann眼压计与NCT眼压计眼压测量值的差异,采用线性相关分析方法分析两种眼压计眼压测量值之间的相关关系,并分析CCT对两种眼压计眼压测量值的影响。结果Goldmann眼压计测得的眼压平均值为（13.46±2.93）mmHg,NCT测得的平均值为（12.29±3.47）mmHg,两者之间差异有显著性（t=5.831,P〈0.001）;两种眼压计眼压测量值呈正相关（r=0.852,P〈0.001）。Goldmann眼压计眼压测量值和NCT眼压测量值均与CCT呈正相关,r值分别为0.424（P〈0.001）和0.568（P〈0.001）。Goldmann眼压计眼压测量值与NCT眼压测量值的差值与CCT呈负相关（r=-0.402,P〈0.001）。去除CCT因素影响后,两种眼压计眼压测量值的残差差异无显著性（t=-0.272,P=0.787）。结论Goldmann眼压计与NCT眼压计眼压测量值均受CCT的影响，CCT对NCT眼压测量值的影响更大；两种眼压计眼压测量值的差异可能来源于个体CCT的差异。     

中央角膜厚度及屈光度对压平眼压计测量值的影响

目的 探讨中央角膜厚度(CCT)以及屈光状态对Goldmann压平眼压计(GAT)测量值的影响.方法 应用OCT3测量正常人121例(199只眼)与近视患者81例(159只眼)的CCT,用Goldmann压平眼压计测量眼压,比较两组之间CCT和眼压测量值的差异,分析CCT与眼压测量值的关系.结果 正视组平均CCT值为(525.05±32.83)μm,眼压的均值为(12.91±2.26)mmHg;近视组平均CCT值为(524.85±29.76)μm,眼压的均值为(14.23±2.54)mmHg;两组的CCT值比较差异无显著性(t=-0.600,P=0.952),两组的眼压值比较差异有显著性(t=-5.139,P＜0.001).高度近视眼CCT偏薄,眼压随屈光度数较少而增加,近视组眼压与屈光度相关(r=-0.296,P＜0.001),屈光度数每增加-4.05D,眼内压升高1 mmHg.正视组(r=0.317,P＜0.001)和近视组(r=0.341,P＜0.001)的眼压与CCT相关,眼压校正公式分别为1 mmHg/45.45 μm、1 mmHg/34.48 μm.结论 CCT可以影响Goldmann压平眼压计测量值,屈光状态也可以影响眼压值,高度近视眼的眼压建议用从近视人群中获得的眼压校正公式校正.     

非接触式眼压计与Goldmann压平眼压计测量眼压的比较

目的 :比较非接触式眼压计 ( NCT)和 Goldm ann压平眼压计测量眼压的差异。方法 :对 112例 ( 2 2 0眼 )志愿者分别进行 NCT和 Goldmann压平眼压计眼压测量及中央角膜厚度测量 ,并对其中 16 8眼进行自动验光检查。结果 :NCT和 Goldmann眼压计眼压测量值分别为 1.98± 0 .6 9k Pa和 2 .34± 0 .77k Pa。 NCT眼压测量值较 Goldmann眼压测量值偏低 0 .36± 0 .37k Pa( P<0 .0 5 )。眼压在 1.33～ 2 .6 7k Pa内 ,二种眼压计测量眼压值偏差最小。角膜厚度和眼球屈光度与 NCT眼压测量值分别呈明显正相关和负相关。结论 :NCT眼压测量值较Goldmann眼压测量值偏低 ,NCT眼压值为临界眼压时 ,应应用 Goldm ann压平眼压计校正     

动态轮廓眼压计与Goldmann压平眼压计及非接触眼压计测量眼压的对比研究

目的探讨动态轮廓眼压计(DCT)与Goldmann压平眼压计(GAT)及非接触眼压计(NCT)测量眼压的准确性,并比较三种眼压计测量结果与中央角膜厚度(CCT)的相关性。设计前瞻性、比较性病例系列。研究对象连续选取90例(90眼)10~76岁正常人。方法采用KONAN非接触式角膜内皮镜测量CCT后,对所有入选者单眼以随机顺序采用Pascal型DCT、GAT及Topcon型NCT测量眼压。测量结果两两比较,并将眼压值与CCT进行直线回归分析。主要指标眼压值,Pearson相关系数。结果 90例正常人DCT眼压平均值(17.33±2.71 mm Hg)明显高于GAT(14.27±2.81 mm Hg)(P=0.000)及NCT(14.67±2.93 mm Hg)(P=0.000),平均差异分别为(3.06±2.01)mm Hg和(2.67±2.20)mm Hg;GAT与NCT之间平均差异为(-0.39±2.29)mm Hg(P=0.105)。DCT与GAT眼压值之间相关系数r=0.736(P=0.000);与NCT眼压值之间相关系数r=0.699(P=0.000)。GAT、NCT眼压值与CCT均明显相关(r=0.370,P=0.000;r=0.508,P=0.000);DCT眼压值与CCT无明显相关性(r=0.051,P=0.639)。DCT和GAT的差值与年龄无明显相关性(r=0.064,P=0.052)。结论 DCT测量的眼压值虽高于GAT及NCT,但不受CCT的影响,可能较GAT和NCT测量的眼压值更接近真实值。     

Goldmann压平眼压计与非接触式眼压计测量眼压的对比研究

目的:比较Goldmann压平眼压计(Goldmannapplanationtonometer,GAT)与非接触眼压计(non-contacttonometer,NCT)测量眼压的差异,以评价NCT与GAT测量的相关性。方法:对265例志愿者(529眼)分别采用Goldmann压平眼压计与非接触眼压计测量眼压。结果:非接触眼压计的测量结果低于Goldmann压平眼压计,且差异有显著性(19.13vs23.43,t=22.644,P<0.01),随眼压值的升高,两者相差幅度增大,差异在眼压〉30mmHg时更为明显,但相关系数逐渐变小。结论:非接触眼压计眼压测量值较Goldmann眼压测量值偏低,非接触眼压计眼压值为临界眼压时,需应用Gold-mann压平眼压计校正,以便及时发现病理性眼压升高,避免青光眼的漏诊和失治。     

非接触式眼压计与Goldmann压平眼压计测量眼压的比较

目的:比较非接触眼压计(non-contacttonometer,NCT)与Goldmann压平眼压计(GAT)测量眼压的差异,以评价非接触式眼压计在临床青光眼患者及疑似青光眼患者中的的应用价值。方法:志愿者174例348眼分别由专人进行非接触眼压计(NCT)与Goldmann压平眼压计眼压测量。结果:非接触眼压计(NCT)的测量结果低于Gold-mann压平眼压计且差异有显著性(19.6vs23.4,P<0.05),两者相关系数为r=0.783,差异在眼压>30mmHg组更为明显,相关系数为0.334。结论:非接触眼压计(NCT)可以用于临床普查,在青光眼的临床工作中建议使用Goldmann压平眼压计矫正。     

动态轮廓眼压计与非接触眼压计的比较

目的比较动态轮廓眼压计（DCT）与非接触眼压计（NCT）测量眼压的差异，并探讨中央角膜厚度（CCT）对这两种测量方法的影响。方法对75例拟接受近视手术的患者进行角膜厚度测量后，对所有眼分别用DCT和NCT进行眼内压（IOP）的测量，并比较中央角膜厚度与两种眼压计读数的关系。对所有数据进行t检验和相关分析。结果NCT和DCT测得的眼压值具有显著性差异（t=9．2932，P〈0．01）。NCT测量值与CCT呈正相关，相关系数r=0．3482（P〈0．01）。DCT测量值与CCT无相关性，相关系数r=0．0635，P〉0．05）。结论NCT和DCT测量眼压值有差异，DCT测量值大于NCT，CCT对NCT的影响大于DCT。     

中央角膜厚度对3种眼压计眼压测量值的影响

目的比较分析不同中央角膜厚度(central corneal thickness,CCT)下Icare回弹式眼压计、Goldmann压平式眼压计(Goldmann applanation tonometer,GAT)和动态轮廓眼压计(dynamic contour tonometry,DCT)的眼压测量结果,探讨CCT对3种眼压计测量值的影响。方法 对78例患者152眼分别用Icare、GAT、DCT3种眼压计进行眼压测量,并进行CCT的测量,对比不同CCT下3种眼压计的测量结果,分析眼压测量值与CCT的关系。结果 在全部受测者中Icare、GAT、DCT测得的眼压均值分别为(19.16±5.03)mmHg(1 kPa=7.5 mmHg)、(18.41±4.52)mmHg和(17.23±3.69)mmHg,三者之间有显著差异(F=7.256,P=0.001)。Icare和GAT的眼压测量值均与CCT显著相关(r=0.341,P<0.001;r=0.333,P<0.001),CCT每改变10μm,Icare的眼压值改变0.47 mmHg,GAT的眼压值改变0.41 mmHg;而DCT的眼压测量值与CCT无显著相关(r=0.032,P=0.699)。结论 Icare、GAT的眼压测量值均明显受CCT的影响,而Icare受CCT影响的程度较GAT的稍大,DCT的眼压测量值基本不受CCT的影响。     

非接触眼压计测量的评价——与Goldmann眼压计的比较

目的 :对比非接触式眼压计 (NCT)与Goldmann眼压计所测量的眼压值以评价非接触式眼压计在临床的应用价值。方法 :10 5例 2 0 9只眼纳入本观察 ,其中 14 2只眼作了验光、眼轴及角膜曲率测量 ,并调查患者对两种眼压计的接受度。结果 :两种眼压计测量结果的相关系数为 0 975 ,两者差异有显著性 (t值 -7 949,P <0 0 0 1)。非接触式眼压计的测量结果高于Goldmann眼压计 ,尤其在眼压 >2 1mmHg组更为明显 (t值 -5 5 0 6,P <0 0 0 1)。角膜曲率、屈光度、散光、眼轴与两者测量值间差d无相关性 ,相关系数分别为 -0 0 5 4,-0 0 41,-0 13 5 ,0 113 ,P值均 >0 0 5。患者对非接触式眼压计的接受程度大于Goldmann眼压计结论 :非接触式眼压计可用于临床普查 ,但在青光眼的临床工作中建议使用Goldmann压平式眼压计     

三种眼压计与Pentacam眼压校正系统的应用比较

目的:比较非接触式眼压计(NCT)、Goldmann压平式眼压计(GAT)、动态轮廓眼压计(DCT)和Pentacam三维眼前节分析系统四种方法检查眼压的差异,并研究它们与中央角膜厚度(CCT)和中央角膜曲率(CCV)的关系。方法:对拟行LASIK手术的143例286眼患者用Pentacam系统测量CCT和CCV后,分别用NCT,GAT和DCT测量眼压,并用Pentacam系统的Ehlers,Shah,Dresden,Orssengo/Pye和Kohlhaas5种眼压校正方法对NCT眼压值进行校正,将测量结果进行方差分析、相关性及线性回归分析。结果:DCT值最高,DCT与其他方法之间均有显著性差异(P<0.01);GAT与DCT,Kohlhaas,Shah之间有差异(P<0.05),与其他方法之间无差异;各组眼压值之间有较好的相关性,GAT与DCT的相关性最强(r=0.702);NCT受CCT影响最大,GAT受CCV影响最大,DCT,Dresden,Orssengo/Pye,Shah与CCT和CCV均不存在相关性(P>0.05)。结论:对CCT和CCV正常的健康人群进行青光眼筛查时建议使用压平式眼压计,对可疑的患者,尤其是CCT和CCV偏离正常的患者,宜进一步行DCT检查或者用Pentacam系统进行眼压校正。     

Diaton眼压计与非接触式眼压计测量眼压的比较

目的比较Diaton眼压计（DT）与非接触式眼压计（NCT）测量眼压的差异。方法分别使用DT和NCT测量患者眼压,对测量值进行统计学分析,多元相关分析研究眼压测量值与年龄、角膜曲率、等效球镜度、中央角膜厚度之间的相关性。结果 DT与NCT的平均眼压测量值分别为（13.81±3.27）mmHg和（15.80±3.48）mmHg,差异有统计学意义（P〈0.05）,二者测量值的相关系数r=0.438,P〈0.05,两种眼压计的测量差值随中央角膜厚度增加而升高;将所有患者依照中央角膜厚度分为3组,NCT测量值在3组间有显著差异,而NCT测量值在3组间无差异;NCT测量值与年龄和中央角膜厚度呈正相关,而DT测量值与年龄、角膜曲率、等效球镜度、中央角膜厚度均不相关。结论 Diaton眼压计测量值不受年龄和中央角膜厚度影响,与非接触式眼压计测量值呈正相关,可应用于临床普查和诊断。     

Influence of corneal thickness on comparative intraocular pressure measurements with Goldmann and non-contact tonometers in keratoconus

BACKGROUND: The influence of corneal thickness and curvature on the difference between intraocular pressure (IOP) measurements obtained with non-contact (NCT) and those with the Goldmann applanation tonometer (GAT) was studied in patients with keratoconus. MATERIALS AND METHODS: We examined 113 patients with keratoconus. IOP was measured by the Canon TX 10 non-contact tonometer and the Goldmann tonometer, corneal curvature and thickness were obtained by Humphrey Automatic Refractometer Keratometer and Orbscan Version 3.0 Bausch & Lomb Surgical. RESULTS: The IOP measured by NCT was significantly lower than that measured by GAT. The mean pachymetry of the thinnest point was 423.15 +/- 98.43 microm for the right eyes and 426.7 +/- 93.88 microm for the left eyes. The difference between NCT-GAT and corneal thickness showed a significant negative correlation (r = - 0.427, p < 0.0001; t = - 3.677, p < 0.0001). Values of NCT measurements were significantly increasing with corneal thickness (F = 6.505, p < 0.0001 for right eyes and F = 4.37, p = 0.004 for left eyes), whilst GAT measurements did not show a significant influence of the corneal thickness. The keratometry had no effect on the difference between NCT-GAT measurements (t = 1.090, p = 0.278). CONCLUSIONS: The thin cornea has more influence on the measurement with NCT than GAT. The relative precision of NCT compared with GAT seems to be influenced by the corneal thickness.     

The Influence of Corneal Thickness and Curvature on the Difference Between Intraocular Pressure Measurements Obtained with a Non-contact Tonometer and Those with a Goldmann Applanation Tonometer

Purpose: The influence of corneal thickness and curvature on the difference between intraocular pressure (IOP) measurements obtained with a non-contact tonometer (NCT) and those with a Goldmann applanation tonometer (GAT) was studied.Methods: The corneal thickness and curvature were obtained in 230 eyes of 115 subjects. The correlation between them and ratios of measurement with NCT to that with GAT ([NCT/GAT]) were examined.Results: [NCT/GAT] and corneal thickness showed a significant positive correlation (r = 0.556, P <.01), but, the correlation between [NCT/GAT] and the radius of corneal curvature was not statistically significant (r = -0.035, P =.30).Conclusion: The thick cornea has more influence on the measurement with NCT than GAT, because IOP is measured with NCT over a wider applanation area. The corneas with steeper curvature also cause higher corneal rigidity and produce more overestimation of NCT measurement, while they have stronger capillary attraction of the precorneal tear film for the GAT tip and also produce overestimation of GAT measurement. As a result, [NCT/GAT] was believed to be not influenced by the corneal curvature.     

角膜厚度对三种不同眼压计测量的影响

目的:比较采用Goldmann压平眼压计(Goldmann applanation tonometer,GAT)、非接触眼压计(non-contact tonometer,NCT)和Schiotz眼压计(Schiotz tonometer,ST)的眼压(intraoeular pressure,IOP)测量,评估角膜中央厚度(central corneal thickness,CCT)对读数的影响。方法:使用GAT、NCT和ST对所有患者的右眼进行眼压测量。超声角膜厚度测量法测定CCT。所有IOP及CCT测量由同一检查者进行。计算CCT25%(Q1)百分位数和75%(Q3)百分位数值,并通过这种方法将该组分为薄、中、厚角膜亚组。使用Statplus软件进行统计分析。结果:全系列144眼,GAT测量平均IOP为17.4±4.9mmHg,NCT为16.0±5.8mmHg,ST为14.0±4.0mmHg(Friedman方差分析P<0.01)。IOP水平和CCT之间的相关系数NCT为0.787(P<0.01),GAT为0.630(P<0.01),ST为0.565(P<0.01)。ST测量中,纠正的IOP误差和CCT之间的相关性在厚角膜明显弱(r=0.381,P=0.022)。结论:NCT是最易受不同CCT影响的设备。ST读数似乎比GAT和NCT读数受CCT的影响小。特别是在厚角膜,与NCT和GAT相比,ST可以被认为是一个更可靠的仪器。     

五种眼压计测量眼压的一致性比较及其与角膜生物力学的相关性

目的 比较非接触眼压计（气流眼压）、Goldmann压平眼压计（压平眼压）、Icare pro回弹眼压计（回弹眼压）、Tono-pen AVIA眼压计（笔式眼压）和可视化角膜生物力学分析仪（生物力学眼压）测量眼压的一致性,进一步分析眼压和角膜生物力学的相关性。设计 诊断方法评价。研究对象 健康志愿者44例。方法 同一医师每天同一时段分别应用上述五种眼压计测量受试者的左眼眼压。将眼压与中央角膜厚度、角膜第一压平时间进行Pearson相关分析。主要指标 眼压值、眼压差值的平均值、相关系数。结果 压平眼压、气流眼压、回弹眼压、笔式眼压和生物力学眼压5种眼压结果分别为（15.9±3.3）mmHg、（14.8±2.9）mmHg、（16.9±3.3）mmHg、（14.7±2.5）mmHg和（16.1±3.0）mmHg。其中,气流眼压、笔式眼压较压平眼压低（P=0.01,0.00）。气流眼压、回弹眼压、笔式眼压、生物力学眼压均与压平眼压正相关（r=0.63、0.37、0.63、0.55,P均＜0.05）;Bland-Altman分析两种测量方式眼压差值平均值分别为：气流眼压与压平眼压：-1.1 mmHg [95%一致性界限（95% LoA）为-6.4,4.2],笔式眼压与压平眼压：-1.2 mmHg（95% LoA -6.3,3.9）,回弹眼压与压平眼压：1.0 mmHg（95% LoA为-6.2,8.3）,生物力学眼压与压平眼压：0.3 mmHg（95% LoA为-5.6,6.2）。所有研究对象中央角膜厚度（550.5±29.2）μm,角膜第一压平时间（7.63±0.36）ms。笔式眼压和中央角膜厚度呈正相关（r=0.40,P=0.01）。五种测试的眼压均与角膜第一压平时间呈正相关（r=0.53,0.64,0.55,0.46,0.99;P均＜0.05）。结论 Icare pro和Corvis ST测量眼压与Goldmann眼压计无明显差异,气流眼压、笔式眼压较压平眼压略低,Corvis ST与Goldmann眼压一致性最好。角膜第一压平时间是影响眼压测量结果的重要因素,时间越长,眼压测量值越高。（眼科, 2020, 29： 365-369）     

Intraocular pressure measurement-comparison of dynamic contour tonometry and goldmann applanation tonometry

PURPOSE: The dynamic contour tonometer (DCT, Pascal tonometer, Swiss Microtechnology AG, Port, Switzerland) was recently introduced as a new method of intraocular pressure measurement, supposedly independent of corneal properties. In this study we analyzed the agreement and correlation of dynamic contour tonometry and Goldmann applanation tonometry (GAT) and investigated the influence of central corneal thickness (CCT) and corneal curvature. We also considered preferential patient groups for both methods. METHODS: In a prospective study of 100 eyes without glaucoma, intraocular pressure was measured using dynamic contour tonometry and Goldmann applanation tonometry, followed by measurements of central corneal thickness and corneal curvature. RESULTS: A clear correlation between dynamic contour tonometry and Goldmann applanation tonometry was found (r = 0.693; P < 0.001). Dynamic contour tonometry generally resulted in higher intraocular pressure measurements (median difference + 1.8 mm Hg, mean difference + 2.34 mm Hg). Unlike dynamic contour tonometry, Goldmann applanation tonometry was remarkably affected by central corneal thickness, but neither method was significantly influenced by corneal curvature. Bland-Altman graphs showed remarkable disagreement between dynamic contour tonometry and Goldmann applanation tonometry, which could be partially explained by the influence of central corneal thickness on Goldmann applanation tonometry. To obtain valid readings, dynamic contour tonometry required a more extensive selection of patients than Goldmann applanation tonometry. CONCLUSIONS: Dynamic contour tonometry seems to be a reliable method for intraocular pressure measurement, which unlike Goldmann applanation tonometry is not influenced by central corneal thickness. In clinical practice, advantages from dynamic contour tonometry can be expected for cooperative patients, outpatients, and patients with sufficient bilateral ocular fixation, whereas Goldmann applanation tonometry measurements are more reliable in case of patients with inadequate cooperation, poor vision, or nystagmus.     

The iCare rebound tonometer: comparisons with Goldmann tonometry, and influence of central corneal thickness

Purpose:  To assess agreement between the iCare rebound tonometer and Goldmann tonometry and to assess the influence of central corneal thickness and the value of scleral rebound tonometer readings.
Methods:  Prospective single-centre cross-sectional study comparing iCare rebound tonometer (RT) intraocular pressure (IOP) readings taken from corneal and scleral locations to Goldmann applanation tonometer (GAT) readings in 100 subjects attending ophthalmology clinics.
Results:  There was a significant difference between RT and GAT, with RT tending to overestimate IOP. The mean difference between RT and GAT measurements was 3.36 mmHg. The mean difference between the log of RT and the log of GAT measurements was 0.2356, a ratio of 1.27 ( P  < 0.0001). A formula derived from a linear regression analysis suggested that a 10% increase in CCT increased the RT IOP reading by 9.9%. Scleral RT readings showed no relationship to GAT readings.
Conclusions:  The rebound tonometer cannot replace the Goldmann tonometer in the office setting given the wide limits of agreement between the two devices. Corneal rebound tonometer readings are influenced by CCT whereas scleral rebound tonometer readings are of no value.