Proview眼压监测计和Goldmann眼压计的比较

目的　评估Proview眼压监测计的准确性。方法　 10 0例青光眼患者 (183眼 ) ,平均年龄5 3 3岁 (16岁～ 74岁 ) ,无角膜病变 ,近 2月无内眼手术史。由专职医师按照Proview眼压监测计使用说明对患者进行解释、示范与指导测量 ,直至患者多次练习后能用Proview眼压监测计加压于眼睑上看见压眼闪光为止 ,休息至少 3 0分钟后 ,医师用Goldmann眼压计测量入选眼的眼压 3次 ,取其平均值。再让患者用Proview眼压监测计测量该眼的眼压 ,连续测量 3次 ,记录其平均值。结果　 10 0例患者中有双眼 96例及独眼 4例 ,其中 83例双眼能见压眼闪光 ,13例仅单眼可见压眼闪光 ,4例独眼患者均可见压眼闪光 ,另 13例未出现压眼闪光的眼均为近绝对期青光眼。Goldmann眼压计测量 183只眼的眼压平均值为 2 0 12mmHg± 5 2 4mmHg(5mmHg～ 3 5mmHg) ,患者自行用Proview眼压监测计测量的眼压平均值为 18 70± 3 49mmHg(8 3mmHg～ 3 0 3mmHg) ,二者差异有显著性意义 (t =5 0 3 8,P =0 0 0 0 )。但眼压在 10mmHg～ 2 1mmHg范围时 (12 3只眼 ) ,两种眼压计的测量值之差仅为 0 12 7±1 15mmHg ,差异无显著性意义 (t=1 2 19,P =0 2 2 5 ) ;其相关系数为 0 83 9,呈密切相关。与Goldmann眼压计比较 :眼压低于 10mmHg(4只眼 ) ,Prov     

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。     

回弹式眼压计在先天性青光眼患者眼压测量中的临床评价

【摘要】 目的 通过与手持压平式眼压计和Schi?觟tz眼压计进行比较评价回弹式眼压计在先天性青光眼患者眼压测量中的价值。设计 诊断技术评价。研究对象 北京同仁眼科中心连续接受眼压测量的平均年龄（12.0 ± 3.0）个月的先天性青光眼患者29例（29眼）。方法 应用回弹式眼压计、Perkins手持压平式眼压计、Schi?觟tz眼压计测量眼压,每种眼压计测量眼压重复三次。主要指标 眼压值,Pearson相关系数（r）。结果 回弹式眼压计、Schi?觟tz眼压计和压平式眼压计所测眼压平均值分别为（19.3±8.5）mm Hg、（21.1±10.8）mm Hg和（18.5±7.8）mm Hg（F=0.61,P=0.55）。回弹式眼压计与手持压平眼压计的平均差值为（0.8±2.4）mm Hg。Schi?觟tz眼压计与手持压平眼压计平均差值为（2.6±2.4）mm Hg,Schi?觟tz眼压计与回弹眼压计的平均差值为（1.8±2.4）mm Hg。回弹式眼压计与手持压平式眼压计（r=0.934,P=0.000）、Schi?觟tz眼压计（r=0.933,P=0.000）眼压值均显著相关。结论 回弹式眼压计的准确性可满足先天性青光眼患者眼压测量的需求。（眼科,2012,21：278-281）     

眼压测量仪器新进展

Goldmann压平眼压一直以来被认为是眼压测量的"金标准",但研究发现其在临床应用上仍有一定的局限性.随着科技的发展,新的眼压测量仪器不断被研发面世,以期能为临床提供更为简便、精确的眼压测量方法.其中回弹式眼压计操作简单、无需表面麻醉,临床上可适用于角膜有病变患者或者配合程度较差患者的眼压测量;眼反应分析仪不但可以测量出不受角膜因素影响的角膜补偿眼压,还可以测量角膜生物力学特性;动态轮廓眼压计测量的眼压不受中央角膜厚度、角膜曲率等角膜特性影响,且能同时获得眼脉动幅度;压眼闪光眼压计不受角膜形态影响,并且患者可自行在家测量.本文就这几种新兴的眼压测量仪器的研究新进展作一简要综述.     

眼压测量仪器新进展

Goldmann压平眼压一直以来被认为是眼压测量的"金标准",但研究发现其在临床应用上仍有一定的局限性.随着科技的发展,新的眼压测量仪器不断被研发面世,以期能为临床提供更为简便、精确的眼压测量方法.其中回弹式眼压计操作简单、无需表面麻醉,临床上可适用于角膜有病变患者或者配合程度较差患者的眼压测量;眼反应分析仪不但可以测量出不受角膜因素影响的角膜补偿眼压,还可以测量角膜生物力学特性;动态轮廓眼压计测量的眼压不受中央角膜厚度、角膜曲率等角膜特性影响,且能同时获得眼脉动幅度;压眼闪光眼压计不受角膜形态影响,并且患者可自行在家测量.本文就这几种新兴的眼压测量仪器的研究新进展作一简要综述.     

眼压测量仪器新进展

Goldmann压平眼压一直以来被认为是眼压测量的"金标准",但研究发现其在临床应用上仍有一定的局限性.随着科技的发展,新的眼压测量仪器不断被研发面世,以期能为临床提供更为简便、精确的眼压测量方法.其中回弹式眼压计操作简单、无需表面麻醉,临床上可适用于角膜有病变患者或者配合程度较差患者的眼压测量;眼反应分析仪不但可以测量出不受角膜因素影响的角膜补偿眼压,还可以测量角膜生物力学特性;动态轮廓眼压计测量的眼压不受中央角膜厚度、角膜曲率等角膜特性影响,且能同时获得眼脉动幅度;压眼闪光眼压计不受角膜形态影响,并且患者可自行在家测量.本文就这几种新兴的眼压测量仪器的研究新进展作一简要综述.     

Tono-Pen眼压计与Goldmann眼压计的临床比较

目的:了解Tono-Pen眼压计的临床实用性。方法:62例(111只眼)随机先后用Tono-Pen眼压计与Goldmann眼压计进行眼压测量,比较两种眼压计测量值的差异。结果:111只眼中,用Goldmann眼压计测量的眼压平均值为(15.82±4.88)mmHg,用Tono-Pen眼压计测量的眼压平均值为(16.34±4.33)mmHg,两者有显著性差异。眼压在9～30mmHg范围时,两种眼压计的测量值之差为(-0.51±2.24)mmHg,差异无显著性。在眼压低于9mmHg时,有过高估计眼压的趋向;在眼压高于30mmHg时,有过低估计眼压的趋向。Tono-Pen眼压计与Goldmann眼压计的相关系数为0.865,呈密切相关。结论:Tono-Pen眼压计与Goldmann眼压计有很好的相关性,尤其是在眼压为9～30mmHg范围。眼科学报 2002;18:226-229.     

眼压测量仪器新进展

Goldmann压平眼压一直以来被认为是眼压测量的“金标准”,但研究发现其在临床应用上仍有一定的局限性。随着科技的发展,新的眼压测量仪器不断被研发面世,以期能为临床提供更为简便、精确的眼压测量方法。其中回弹式眼压计操作简单、无需表面麻醉,临床上可适用于角膜有病变患者或者配合程度较差患者的眼压测量;眼反应分析仪不但可以测量出不受角膜因素影响的角膜补偿眼压,还可以测量角膜生物力学特性;动态轮廓眼压计测量的眼压不受中央角膜厚度、角膜曲率等角膜特性影响,且能同时获得眼脉动幅度;压眼闪光眼压计不受角膜形态影响,并且患者可自行在家测量。本文就这几种新兴的眼压测量仪器的研究新进展作一简要综述。     

PASCAL动态轮廓眼压计临床应用的初步报告

目的:验证动态轮廓眼压计(DCT)的临床性能。方法:对81例143眼青光眼及可疑病例青光眼患者用DCT测量眼内压(IOP);132眼同时用Goldmann压平眼压计(GAT)测量眼压,部分病例同时用NIDEKUP-1000型角膜测厚仪测量中央角膜厚度(CCT)。GAT与DCT测量结果采用配对t检验,GAT、DCT测量值与CCT的关系及DCT测量值与眼脉动振幅(OPA)的相关关系采用Spearman双变量相关分析。结果:①DCT和GAT测得的眼压均数分别为(18.6±3.9)mmHg和(17.4±4.1)mmHg;DCT测得的眼压值高于GAT,其差值均数为(1.1±2.3)mmHg;两种眼压计测得的眼压值呈正相关(r=0.83,P<0.01)。②116眼同时完成了DCT眼压测量及CCT测量,两者相关系数r=0.03,P=0.77;113眼同时完成了GAT眼压测量及CCT测量,两者相关系数r=0.28,P=0.003。③143眼同时记录了DCT眼压值和眼脉动振幅(OPA),其均数分别为(18.6±3.9)mmHg和(2.6±1.1)mmHg,两者的相关系数r=0.32,P<0.01。结论:以上结果初步证实:①DCT眼压计测量值与GAT眼压测量值高度相关,但DCT测量值略高于GAT测量值,提示DCT可用于临床诊断。②DCT测量值与CCT不相关,GAT测量值与CCT显著相关,提示DCT在青光眼诊断中有独特优势。③DCT测量的OPA与IOP值显著相关,相关的机制及临床意义有待探讨。     

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.     

Comparison of intraocular tonometry using three different non-invasive tonometers in children

Background

In childhood glaucoma, the correct determination of intraocular pressure (IOP) is crucial in clinical decision-making. We therefore investigated how intraocular tonometry readings correlate with readings from commonly used tonometers.

Methods

IOP was measured unilaterally in 20 children suffering from congenital (n = 7) or secondary glaucoma (n = 13), 10 minutes after the induction of general anaesthesia. The children were aged from 1 month to 17 years (mean age 4.3 years, median age 1.3 years). Non-invasive applanation (Tono-Pen XL, Perkins tonometer) and indentation tonometry (Schiötz tonometer) were performed in random order prior to intraocular tonometry with a 26-gauge needle connected to a pressure sensor. Linear regression analysis and the coefficients of variance (CV) were used to compare the data obtained from the various tonometers.

Results

Compared with intraocular pressure, the CV was 10% for the Tono-Pen XL, 17% for the Schiötz, and 19% for the Perkins tonometer. The coefficient of determination (r²) was 0.74 for Tono-Pen XL, 0.60 for Schiötz and 0.78 for Perkins tonometry. The IOP values obtained with the Tono-Pen XL scattered homogeneously around the intraocular IOP, while the Perkins and Schiötz tonometers underestimated intraocular measured IOP.

Conclusion

Of the three tonometers evaluated in this series of paediatric glaucoma patients, the Tono-Pen XL most closely reflected true IOP.     

Intraocular pressure measurements with the Proview self-tonometer in comparison of Goldmann applanation tonometry in healthy and glaucomatous eyes

BACKGROUND: The aim of this study was to compare the results of intraocular pressure (IOP) measurements obtained using the pressure phosphene tonometer Proview with those from Goldmann applanation tonometer (GAT) in normal and glaucomatous eyes. PATIENTS AND METHODS: The IOP in 150 eyes of 62 healthy volunteers and 88 patients with glaucoma or ocular hypertension was measured prospectively in a sitting position. After being trained to use the Proview device, Goldmann applanation tonometry was performed first. Then the patient took a reading with the Proview self-tonometer. RESULTS: For all investigated eyes the measurements with the Proview were on average 5.5 mmHg higher than those by GAT. Only 34 % of the readings from the two devices were within a difference range of +/- 3 mmHg. On comparing the group of glaucomatous patients with slight visual field defects with the group of healthy subjects and patients with ocular hypertension without visual field defects we determined almost the same mean difference between the Proview and GAT (mean difference in the group with visual field defects = 4.7 +/- 4.1 mmHg; without defects = 4.8 +/- 2.9 mmHg). CONCLUSIONS: The tonometer Proview did not show a close agreement to GAT. Therefore, the PPT does not offer an alternative method for measuring IOP. We do not recommend the Proview for self-tonometry at home or for clinical management of patients with glaucoma. Slight visual field defects seem to have no influence on intraocular pressure measurement with the self-tonometer.     

Goldmann tonometry versus the Tono-Pen XL for intraocular pressure measurement: an evaluation of the potential impact on clinical decision making in glaucoma

Aim:  To assess the validity of the Tono-Pen XL as an alternative to the Goldmann applanation tonometer (GAT) for the measurement of intraocular pressure (IOP) in patients with ocular hypertension (OHT) and glaucoma.
Methods:  Over a 3 month period, patients with OHT or glaucoma attending a general clinic had IOP measurements taken using the Tono-Pen XL and the GAT. Tono-Pen measurements were taken by suitably trained nursing staff, while Goldmann tonometry was performed by the examining ophthalmologist.
Results:  There were 124 eyes of 62 patients in this study. Overall, mean IOP was 18.3 ± 4.8 mmHg using GAT and 18.8 ± 5.5 mmHg using the Tono-Pen. Using the Bland–Altman method, the upper and lower limits of agreement between the two devices were +10.6mmHg and −9.6 mmHg, respectively. Significant over- and under-estimates of IOP were noted in 10 (16%) patients.
Conclusion:  Our findings suggest that the Tono-Pen XL cannot be used as a substitute for GAT in the management of patients with glaucoma or OHT.     

Clinical comparison of the ProTon and Tono-Pen tonometers with the Goldmann applanation tonometer.

A clinical evaluation of a new electron ProTon tonometer was performed comparing the values of intraocular pressure (IOP) measured using this instrument with those determined by a similar instrument, Tono-Pen XL, and by Goldmann applanation tonometry. The mean IOP measured in 106 eyes with the ProTon tonometer was not significantly different from that determined with Goldmann applanation, while the IOP values measured with Tono-Pen XL were significantly lower. The 95% limits of agreement between applanation tonometry and ProTon tonometry were between -4 mm Hg and 5 mm Hg and between applanation tonometry and Tono-Pen XL tonometry between -3 mm Hg and 8 mm Hg. The ProTon tonometer appears to have a higher level of accuracy than the Tono-Pen XL tonometer in clinical practice.     

Poor utility of intraocular pressure correction formulae in individual glaucoma and glaucoma suspect patients

Background: To compare Pascal dynamic contour tonometry (DCT) measurements with Goldmann applanation tonometry (GAT) readings after adjustment with correction formulae in a population of Caucasian glaucoma and glaucoma suspect patients. Design: Retrospective cross‐sectional case series in a specialist glaucoma practice. Participants: Consecutive glaucoma and glaucoma suspect Caucasian patients. Methods: Case notes review of the GAT and DCT intraocular pressure (IOP) measurements from patients who presented on a non‐acute basis over a 30‐month period. The GAT measurement was adjusted with six different correction formulae. Agreement between GAT IOP, adjusted GAT IOP and DCT IOP was evaluated with the Bland‐Altman analysis. Main Outcome Measures: Agreement between GAT IOP (both unadjusted and adjusted) and DCT IOP. Results: Data from 200 patients with a mean age of 58.4 (±12.7) years were analysed. The mean central corneal thickness was 554.8 (±36.9) µm and the mean corneal hysteresis was 9.8 (±1.9) mm Hg. Sixty five (32.5%) had confirmed glaucomatous optic neuropathy. GAT IOP demonstrated poor agreement with DCT IOP. GAT IOP was on average 2.1 mm Hg less than DCT IOP. None of the six correction formulae resulted in improved agreement with DCT IOP. General linear model analysis found no statistically significant measurement differences between the glaucoma and glaucoma suspect groups. Conclusions: GAT demonstrated poor agreement with DCT, and agreement did not improve after adjustment with correction formulae. Our results suggest that correction formulae for GAT IOP are unsuitable to clinically approximate ‘true’ IOP in Caucasian glaucoma and glaucoma suspect patients.     

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.     

Level of disagreement between Proview phosphene tonometer and Goldmann applanation tonometer intraocular pressure readings

PURPOSE: To evaluate the agreement of intraocular pressure (IOP) readings obtained with the Proview phosphene tonometer and those obtained by Goldmann applanation tonometry as well as the effect of regular use of the Proview on patients' anxiety about their glaucoma. METHODS: One hundred thirty-five consecutive patients with glaucoma, 35 designated as controls, were enrolled in a 10-month randomized prospective clinical trial. The study patients but not the controls used the Proview outside the office. At office visits IOP was measured by an ophthalmologist with the Goldmann applanation tonometer (GAT) as well as by examiners and patients using the Proview. Patients in the treatment group (n = 100) were asked to measure and record their IOP at home as well. Using ANOVA, we examined the relationship between demographic variables and the level of agreement between the Proview readings and those measured by GAT at the final office visit. All participants also were asked to complete a questionnaire regarding their anxiety about their IOP at the baseline and final office visits. The primary outcome measure was the level of agreement of the Proview measurements with those obtained by GAT. Secondary outcome measures included patients' anxiety about their glaucoma. RESULTS: The absolute mean difference between GAT and Proview readings at the final visit was 3.5 +/- 2.9 mm Hg (median, 2.8 mm Hg). The treatment group reported significantly less anxiety about their glaucoma after 4 to 6 weeks of using the Proview (P = .024). CONCLUSIONS: There was considerable discrepancy between Proview and GAT readings. However, regular use of the Proview tonometer significantly reduced patients' anxiety about their glaucoma.     

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.