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International Ophthalmology
Published in: International Ophthalmology 1/2020

01-01-2020 | Glaucoma | Original Paper

A comparison of Icare PRO and Perkins tonometers in anesthetized children

Authors: Massimiliano Serafino, Edoardo Villani, Andrea Lembo, Giovanni Rabbiolo, Claudia Specchia, Rupal H. Trivedi, Paolo Nucci

Published in: International Ophthalmology | Issue 1/2020

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Abstract

Aim

To compare intraocular pressure (IOP) measurements obtained with the Perkins applanation tonometer and Icare PRO (ICP) rebound tonometer in anesthetized aphakic or strabismus children. Furthermore, intra-operator correlation and inter-operator correlation have been evaluated, along with the effects of central corneal thickness (CCT) on IOP measurements.

Methods

Seventy children undergoing examination under anesthesia with sevoflurane for aphakic patients and for surgery for strabismus were included. IOP have been measured twice immediately after anesthesia induction with both Perkins applanation tonometer (PAT) and ICP in one eye and by two different operators with both devices in the fellow eye. Furthermore, CCT was measured with ultrasound pachymetry Pacline (Optikon). Agreement between the device measurements has been evaluated using Bland–Altman analyses. Repeatability and reproducibility of the device have been evaluated with intraclass correlation coefficient (ICC) with a value > 0.75 associated with excellent reliability. The relationship between IOP and CCT has been evaluated with Spearman’s correlation coefficient r and determination coefficient r2.

Results

Mean difference in IOP measurements between ICP and PAT was 1.97 mmHg ± 1.23 mmHg (p < 0.05). This difference appeared to be higher in aphakic patients (mean difference 2.15 ± 1.35) than in patients undergoing strabismus surgery (mean difference 1.83 mmHg ± 1.12). Intraclass correlation coefficient (ICC) is used to evaluate repeatability and reproducibility, which are both high for PAT (repeatability 0.96, reproducibility 0.76) compared with ICP (repeatability 0.81, reproducibility 0.70). Correlation coefficient between CCT and IOP is 0.66 for both ICP and PAT.

Conclusion

ICP tends to overestimate IOP compared to PAT. Repeatability and reproducibility are both high for PAT as compared to ICP. A significant correlation between IOP and CCT for both instruments has been demonstrated.
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Metadata
Title
A comparison of Icare PRO and Perkins tonometers in anesthetized children
Authors
Massimiliano Serafino
Edoardo Villani
Andrea Lembo
Giovanni Rabbiolo
Claudia Specchia
Rupal H. Trivedi
Paolo Nucci
Publication date
01-01-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01143-3

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