动态轮廓眼压计与压平眼压计的比较

目的:评价和比较动态轮廓眼压计和Goldmann压平眼压计测得的LASIK手术后眼压值。方法:接受准分子激光原位角膜磨镶术(LASIK)的近视患者34例68眼,分别于术前和术后3mo使用动态轮廓眼压计(Pascal dynamic contour tonometer,PDCT)和Goldmann压平眼压计(the Goldmann applanation tonometer,GAT)进行眼压测量。比较手术前后两种测量方法测得的眼压值的差异。多元线性相关分析研究GAT,PDCT测量值和角膜曲率及角膜中央厚度(CCT)之间的相关性。结果:LASIK手术后GAT测量值较术前低,而PDCT值和术前比较差异则无统计学意义。角膜曲率、CCT和GAT读数呈线性相关,而与PDCT读数无关。结论:GAT测量得到的眼压低于实际值。PDCT测眼压不受角膜曲率和中央角膜厚度影响。     

LASIK前后眼压测量方法选择

目的 比较四种常用眼压计在近视准分子激光原位角膜磨镶术(Laserin situ eratomileusis,LASIK)前后的应用,探讨LASIK手术前后眼压测量方式的选择,以做到术前高眼压患者筛查及术后患者青光眼的早期发现.方法 对71例接受LASIK手术近视眼患者按等效球镜分为三组,分别在术前和术后1个月和3个月采用Schiotz眼压计(Schiotztonometer,ST)、Goldmann眼压计(Goldmann applanationtonometry,GAT)、非接触眼压计(non-contacttonometer,NCT)和Tono-Pen眼压计(TP)测量眼压,同时记录手术前后角膜中央厚度.结果 各屈光度组间同时间点相同眼压计测量值差异无统计学意义,术前除GAT、TP外其他眼压计差异有统计学意义,术后各眼压计测量值均降低,TP受角膜变化影响较小,GAT及NCT受影响明显,三者均与术前GAT值相关.ST不受角膜变化影响但其测量值明显偏高且术后与术前GAT无相关关系.结论 术前采用TP或GAT均可,术后应用TP,而NCT可作为术前筛查辅助手段.ST的应用仍有待探讨.     

角膜中央厚度对非接触眼压计测量值的影响

目的：讨论角膜中央厚度对非接触眼压计测量值的影响。方法：测量接受近视眼矫正术患者手术前后的角膜中央厚度、眼压，并进行统计学分析。结果：LASIK和PRK术后角膜中央厚度改变值与NCT测量值改变量的相关系数为0.12，有高度统计学意义；术后眼压值明显低于术前，差异有显著性。结论：角膜中央厚度明显影响非接触眼压计的测量值，手术前眼压值的变化是由于角膜厚度的变化引起。近视度越大，偏低值越明显。     

Diaton眼压计测量准分子激光原位角膜磨镶术后眼压

目的:通过与非接触式眼压计(non-contact tonometer,NCT)的比较,评价Diaton眼压计(DT)在准分子激光原位角膜磨镶术(laser in situkeratomileusis,LASIK)前后眼压测量中的应用价值。方法:在LASIK术前及术后1mo,分别使用NCT和DT测量患者眼压,使用SPSS13.0统计软件对所得结果进行统计学分析。结果:术后1mo时,NCT眼压测量值较术前下降(5.76±2.31)mmHg,DT眼压测量值则无显著差异(t=0.70,P=0.487);NCT与DT读数测量值差值与术中切削量呈正相关,与术后中央角膜厚度呈负相关。结论:Diaton测量眼压不受角膜厚度的影响,因此更适用于LASIK术后患者的眼压测量。     

动态轮廓眼压计与非接触式眼压计的比较

目的探讨中央角膜厚度和角膜曲率对轮廓动态眼压计以及非接触式眼压计眼压测量结果的影响。方法接受准分子激光原位角膜磨镶术(LASIK)的近视患者27例(54只眼),分别于术前和术后第4周使用非接触式眼压计(NCT)和动态轮廓眼压计(DCT)进行眼压测量。多元线性相关分析研究NCT、DCT测量值和角膜曲率及角膜中央厚度(CCT)之间的相关性。结果LASIK术后NCT测量值降低,而DCT测量值和术前比较差异则无统计学意义。角膜曲率、CCT和NCT读数呈线性相关,而与DCT读数无关。结论DCT测量眼压不受角膜曲率和中央角膜厚度影响,因此更适合于正常眼以及曾经接受角膜屈光手术眼的眼压测量。     

角膜厚度对两种眼压测量方法的影响

目的　比较非接触眼压计 (non -contacttonometer ,NCT)和Goldmann压平眼压计测量眼压的差异 ,并分别探讨中央角膜厚度 (centralcornealthickniss ,CCT)对这两种测量方法的影响。方法　对 1 0 8例拟接受PRK或LASIK手术的患者行CCT ,NCT和Goldmann压平计眼压测量。结果NCT和Goldmann压平眼压计测得的眼压均值具有显著性差异 (F =89 .70 4 4,P <0 . 0 1 )。CCT与NCT和Goldmann压平眼压计测量值呈正相关 ,相关系数分别是r =0. 4 96 0 (t =8 .356 3,P <0 .0 0 1 )和r =0 . 2 1 1 3(t =3. 1 6 2 3,P <0 .0 0 1 )。结论　NCT和Goldmann压平眼压计测量眼压值有差异 ,NCT测量值大于Goldmann压平眼压计 ,CCT对NCT的影响大于Goldmann压平眼压计。     

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。     

角膜中央厚度和曲率对非接触式眼压计测量值的影响

目的研究角膜中央厚度、曲率对非接触式眼压计(NCT)测量值的影响.方法测量PRK或LASIK术前102例(204眼)患者的角膜中央厚度、角膜曲率、眼压,并将测量结果进行相关及回归统计学处理.结果角膜中央厚度与NCT测量值的相关系数r=0.4846,P＜0.001,有高度统计学意义;角膜曲率与NCT测量值的相关系数r=0.0687,P＞0.05,无统计学意义.结论角膜中央厚度与NCT测量值呈正相关,角膜曲率与NCT测量值之间无相关关系.     

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。     

LASIK术后非接触性眼压测定值的改变

目的:研究准分子激光原位角膜磨削术(laser·in situ keratomileusis,LASIK)术后非接触性眼压计(noncontact tonometer,NCT)测量值的准确性。方法:对180例(256只眼)近视患者行IASIK手术,手术前、后采用NCT测量患者的眼压,并测量角膜厚度和角膜曲率,进行统计学分析。结果:LASIK术后NCT测量值明显低于术前,差异有显著性(P<0.001),术后一年眼压下降(6.54±2.1)mmHg(1 mmHg=0.133 kPa)。术后一年眼压下降值与角膜厚度减少及角膜前表面曲率的降低有关(P<0.01),建立二元回归方程如下:Y=0.355+0.0342X1+0.365X2。Y:术前术后眼压差(mmHg),x1:术前术后角膜曲率差(D),x2:角膜切削厚度(μm)结论:LASIK术后NCT眼压测量值明显低于术前,术后所测量眼压与角膜切削厚度、角膜曲率有关。     

Intraocular pressure and photorefractive keratectomy: a comparison of three different tonometers

PURPOSE: To evaluate the intraocular pressure (IOP) with three different instruments, Goldmann applanation tonometer (GAT), noncontact tonometer, and Tono-Pen after photorefractive keratectomy (PRK) for myopia. METHODS: A prospective case series study to evaluate preoperative and postoperative IOP measurements of 149 eyes at 12 months. We performed GAT, noncontact tonometry, Tono-Pen central, and Tono-Pen temporal periphery measurements. We also performed measurements of the central corneal thickness (CCT) by ultrasonic pachymetry and keratometry. Pre-operative IOP reading served as control for all studies. RESULTS: After PRK, IOP reading was significantly reduced in the treated eyes when compared with the control measurements (11.87+/-1.73 vs. 13.37+/-1.52 mm Hg, p<0.0001 with GAT; 12.07+/-1.6 vs. 13.51+/-1.59 mm Hg, p<0.0001 with noncontact tonometer; 12.18+/-1.6 vs. 13.48+/-1.55 mm Hg, p<0.0001 with Tono-Pen central; 13.48+/-1.65 vs. 13.71+/-1.56 Hg, p<0.0104 with Tono-Pen temporal periphery). There was also a significant correlation between IOP reading changes measured by GAT, noncontact tonometer, Tono-Pen central, and change of CCT and between reduction of IOP reading and keratometry (r2>0.39, p<0.0001 for each). The correlation between IOP reading change by Tono-Pen temporal periphery and CCT was also significant but r2 value was only 0.034. Tono-Pen temporal periphery postoperative IOP measurements had the best correlation with preoperative GAT IOP (r2 = 0.57, p<0.0001). CONCLUSIONS: PRK reduced IOP reading as measured by GAT, noncontact tonometer, and Tono-Pen central; less so when measured by Tono-Pen temporal periphery. Early detection of glaucoma and IOP follow-up in glaucoma patients may be done best by peripheral Tono-Pen measurements over the nonablated cornea.     

The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry

AIMS: To evaluate the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements made with the Goldmann applanation tonometer (GAT), Tono-Pen XL, ocular blood flow tonograph (OBF), and Canon TX-10 non-contact tonometer (NCT). METHODS: CCT was recorded for either eye (randomly selected) of each of 105 untreated patients with ocular hypertension and glaucoma attending the glaucoma research unit at Moorfields Eye Hospital. For each of the selected eyes, IOP was measured with the GAT (two observers), Tono-Pen, OBF, and NCT in a randomised order. The relation of measured IOP and of inter-tonometer differences with CCT and subject age was explored by linear regression analysis. RESULTS: A significant association between measured IOP and CCT was found with each instrument. The change in measured IOP for a 10 mum increase in CCT was 0.28, 0.31, 0.38, and 0.46 for the GAT, Tono-Pen, OBF, and NCT, respectively (all p< or = 0.05). There was a significant association between the NCT/GAT differences and CCT, with a tendency of NCT to overestimate GAT in eyes with thicker corneas. There was a significant association between GAT/Tono-Pen and OBF/Tono-Pen differences and age, with a tendency of GAT and OBF to overestimate the Tono-Pen in eyes of older subjects. CONCLUSION: IOP measurement by all four methods is affected by CCT. The NCT is affected by CCT significantly more than the GAT. Subject age has a differential effect on the IOP measurements made by the GAT and OBF compared to the Tono-Pen.     

Evaluation of intraocular pressure change after laser in situ keratomileusis using the pressure phosphene tonometer

PURPOSE: To evaluate the applicability of pressure phosphene tonometry in measuring intraocular pressure (IOP) after laser in situ keratomileusis (LASIK). SETTING: Baptist Eye Clinic, Kyoto, Japan. METHODS: Thirty-six eyes of 22 consecutive patients who had had LASIK for myopia were enrolled in this prospective comparative study. The mean age of the patients was 32.6 years +/- 9.0 (SD). The IOP was measured using the pressure phosphene tonometer (FPT), Goldmann applanation tonometry (GAT), and noncontact tonometry (NCT). The patients themselves took measurements with the FPT before and 1 week after surgery. One-way analysis of variance followed by a Bonferroni/Dunn multiple comparison post hoc test was administered to compare the preoperative and postoperative measurements with each tonometer. These data were represented graphically using a method described by Bland and Altman. The relationship between each tonometric change and the central corneal thickness (CCT) or keratometry (K) changes after LASIK were evaluated with by Pearson correlation coefficient. RESULTS: Statistically significant differences were found between preoperative and postoperative measurements with GAT and NCT but not with FPT. Preoperative and postoperative FPT readings conformed to the British Standard for reproducibility of a standard test method for IOP estimation. No significant correlation between FPT changes and CCT or K changes was found. CONCLUSIONS: Pressure phosphene tonometry measures IOP through the upper eyelid, and changes in corneal shape do not appear to have an effect on the IOP. The IOP measurements with FPT were constant before and after LASIK.     

Effect of mild to moderate myopic correction by laser-assisted in situ keratomileusis on intraocular pressure measurements with goldmann applanation tonometer,tono-pen,and pneumatonometer

PURPOSE: To evaluate the effect of mild to moderate myopic correction by laser-assisted in situ keratomileusis (LASIK) on intraocular pressure (IOP) measurements with three tonometers: the Goldmann applanation tonometer, Tono-Pen, and pneumatonometer. PATIENTS AND METHODS: In a prospective study of a clinic-based population undergoing elective LASIK surgery for myopia correction, IOP measurements were obtained preoperatively and postoperatively with a Goldmann applanation tonometer, Tono-Pen, and pneumatonometer. Central corneal thickness and keratometric and astigmatism measurements were also obtained before and after surgery. A paired test was used to evaluate the significance of differences between preoperative and postoperative IOP measurements with each instrument. Linear regression was used to correlate IOP measurements with degree of myopia corrected, astigmatism, and central corneal thickness before and after surgery. RESULTS: The study included 66 eyes of 34 individuals with a mean preoperative refractive error of -5.66 + 2.3 D (mean + SD). The reduction of central corneal thickness after LASIK of 0.032 + 0.030 mm (mean + SD) was statistically significant ( < 0.0001). However, there was no statistically significant change in mean IOP after the procedure with the Goldmann applanation tonometer or the Tono-Pen, while the pneumatonometer, was associated with a small but statistically significant decrease in mean IOP of 1.1 mm Hg. CONCLUSION: In this group of patients with mild to moderate myopia, LASIK had little or no statistically significant influence on IOP readings obtained with a Goldmann applanation tonometer, Tono-Pen, or pneumatonometer. This finding is in contrast to earlier reports of greater amounts of myopic correction, in which significant reductions in measured IOP were observed. Further study is needed to determine whether a critical amount of corneal change after LASIK is required to have a significant effect on IOP measurements.     

DCT和GAT对LASIK手术前后眼压的比较性研究

目的 评价动态轮廓眼压计(DCT)和Goldmann压平眼压计(GAT)对在准分子激光原位角膜磨镶术(LASIK)手术前后眼压测量值的变化.方法 取71例141只眼近视患者在LASIK术前和术后一周分别进行角膜厚度(CCT)、GAT、DCT测量.结果 ①LASIK手术前后DCT测得值尤显著性差异(P=0.062),GAT测得值有显著性差异(P＜0.001),CCT测得值有显著性差异(P＜0001).②Bland-Altman分析示LASIK手术前后DCT与GAT两种测量方法均呈现高度一致性.术前DCT测量值高于GAT测量值1.1mmHg,95%可信区间为(-0.6,2.8)mmHg;术后DCT测量值高于GAT测量值8.2mmHg,95%可信区间为(5.3,11.1)mmhg.③△GAT与△CCT呈正相关,△DCT与△CCT无统计相关性.结论 DCT测量值不受LASIK手术切削的影响,更适合于LASIK手术前后眼压的测量.     

Assessment of the Pascal dynamic contour tonometer in monitoring intraocular pressure in unoperated eyes and eyes after LASIK

PURPOSE: To assess the performance of the Pascal dynamic contour tonometer (PDCT) (Swiss Microtechnology AG) by comparing it to Goldmann applanation tonometry (GAT) and noncontact air tonometry (NCT) before and after laser in situ keratomileusis (LASIK). SETTING: Vlemma Eye Institute, Athens, Greece. METHODS: Intraocular pressure was measured in 118 eyes before and 1 and 4 weeks after LASIK using GAT, NCT, and the PDCT, which allows direct, digital, transcorneal measurement of intraocular pressure. RESULTS: Preoperatively, central corneal thickness (CCT) correlated with GAT and NCT measurements but not with PDCT measurements. After LASIK, the mean reduction in CCT ranged from -3.0 to -171.0 microm (median 78 microm). The mean GAT measurement dropped by -4.9 mm Hg +/- 2.7 (SD) at 1 week and was -5.4 +/- 3.0 mm Hg at 4 weeks. Similar drops were observed in NCT measurements. The observed post-LASIK changes in GAT and NCT IOP measurements were not directly proportional to the change in CCT, refractive error, or mean keratometric readings. The preoperative and postoperative PDCT measurements did not differ significantly. CONCLUSIONS: The structural corneal changes induced by LASIK appeared to influence GAT and NCT measurements but not PDCT measurements. Therefore, PDCT may be better suited for monitoring IOP in unoperated eyes and in eyes that have had LASIK.     

Effects of corneal thickness on intraocular pressure measured with three different tonometers

Purpose: To compare intraocular pressure (IOP) measured by a Goldmann applanation tonometer (GAT), a noncontact tonometer (NCT), and a portable noncontact tonometer (PNCT) in eyes of healthy volunteers, and to determine if a significant correlation exists between the IOP and the central corneal thickness (CCT). Methods: A total of 144 healthy participants were randomly assigned to one of two groups; in the first group, IOP was measured first with the NCT and then with the GAT. In the second group, IOP was measured first with the PNCT and then with the GAT. Subsequently, the CCT of all subjects was measured with an ultrasonic pachymeter. Results: The IOPs determined by the GAT and NCT and were strongly correlated, as were those determined by the GAT and PNCT, in both groups. However, a Bland-Altman plot showed that the correlations between the GAT and NCT and between the GAT and the PNCT measurements were not significant. With all three instruments, the IOP readings varied with the CCT. The mean IOPs obtained with the GAT increased by 0.23 mmHg with each 10-μm increase in CCT (0.23 mmHg/10 μm). The comparable value for the NCT was 0.29 mmHg/10 μm, and that for the PNCT was 0.31 mmHg/10 μm. Conclusions: For measurements of IOP in normal eyes, the GAT is the tonometer least affected by the CCT, compared with the PNCT and NCT. A PNCT is more likely to be affected by variations in CCT than the GAT.     

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。