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Published in: BMC Ophthalmology 1/2017

Open Access 01-12-2017 | Research article

Goldmann applanation tonometry error relative to true intracameral intraocular pressure in vitro and in vivo

Authors: Sean McCafferty, Jason Levine, Jim Schwiegerling, Eniko T. Enikov

Published in: BMC Ophthalmology | Issue 1/2017

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Abstract

Background

Goldmann applanation tonometry (GAT) error relative to intracameral intraocular pressure (IOP) has not been examined comparatively in both human cadaver eyes and in live human eyes. Futhermore, correlations to biomechanical corneal properties and positional changes have not been examined directly to intracameral IOP and GAT IOP.

Methods

Intracameral IOP was measured via pressure transducer on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically on each patient alternately to 10, 20, and 40 mmHg. IOP was measured using a Perkins tonometer in the supine position on 58 eyes and upright on a subset of 8 eyes. Twenty one (21) fresh human cadaver globes were Intracamerally IOP adjusted and measured via pressure transducer. Intracameral IOP ranged between 5 and 60 mmHg. IOP was measured in the upright position with a Goldmann Applanation Tonometer (GAT) and supine position with a Perkins tonometer. Central corneal thickness (CCT) was also measured.

Results

The Goldmann-type tonometer error measured on live human eyes was 5.2 +/−1.6 mmHg lower than intracameral IOP in the upright position and 7.9 +/− 2.3 mmHg lower in the supine position (p < .05). CCT also indicated a sloped correlation to error (correlation coeff. = 0.18). Cadaver eye IOP measurements were 3.1+/−2.5 mmHg lower than intracameral IOP in the upright position and 5.4+/− 3.1 mmHg in the supine position (p < .05).

Conclusion

Goldmann IOP measures significantly lower than true intracameral IOP by approximately 3 mmHg in vitro and 5 mmHg in vivo. The Goldmann IOP error is increased an additional 2.8 mmHg lower in the supine position. CCT appears to significantly affect the error by up to 4 mmHg over the sample size.
Literature
1.
go back to reference Leske M, Heijl HM. Factors for glaucoma progression and effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121:48–56.CrossRefPubMed Leske M, Heijl HM. Factors for glaucoma progression and effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 2003;121:48–56.CrossRefPubMed
2.
go back to reference Condon N, Broman A, Bandeen-Roche K. Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol. 2006;141:868–75.CrossRef Condon N, Broman A, Bandeen-Roche K. Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol. 2006;141:868–75.CrossRef
3.
go back to reference Pepose J, Feigenbaum S, Qazi M. Changes in corneal biomechanics and intraocular pressure following LASIK using static, dynamic, and non-contact tonometry. Am J Ophthalmol. 2007;143:39–47.CrossRefPubMed Pepose J, Feigenbaum S, Qazi M. Changes in corneal biomechanics and intraocular pressure following LASIK using static, dynamic, and non-contact tonometry. Am J Ophthalmol. 2007;143:39–47.CrossRefPubMed
4.
go back to reference Susanna JR, De Moraes CG, Cioffi GA, Ritch R. Why do people (still) go blind from glaucoma? Trans Vis Sci Tech. 2015;4(2):1–10.CrossRef Susanna JR, De Moraes CG, Cioffi GA, Ritch R. Why do people (still) go blind from glaucoma? Trans Vis Sci Tech. 2015;4(2):1–10.CrossRef
5.
go back to reference Liu J, Roberts C. Influence of cornea biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg. 2005;31:146–55.CrossRefPubMed Liu J, Roberts C. Influence of cornea biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg. 2005;31:146–55.CrossRefPubMed
6.
go back to reference Kotecha A, Elsheikh A, Roberts C, Haogang Z, Garway-Heath D. Corneal thickness- and age related biomechanical properties of the cornea measured with the ocular response analyzer. IOVS. 2006;47(12):5337–47. Kotecha A, Elsheikh A, Roberts C, Haogang Z, Garway-Heath D. Corneal thickness- and age related biomechanical properties of the cornea measured with the ocular response analyzer. IOVS. 2006;47(12):5337–47.
7.
go back to reference Whitacre M, Stein R. Sources of error with use of Goldmann-type tonometers. Surv Ophthalmol. 2002;38:1–30.CrossRef Whitacre M, Stein R. Sources of error with use of Goldmann-type tonometers. Surv Ophthalmol. 2002;38:1–30.CrossRef
8.
go back to reference Neuburger M, Maier P, Böhringer D, Reinhard T, Jordan FJ. The impact of corneal edema on intraocular pressure measurements using goldmann applanation tonometry, Tono-pen XL, iCare, and ORA: an in vitro model. J Glaucoma. 2013;22:584–90.CrossRefPubMed Neuburger M, Maier P, Böhringer D, Reinhard T, Jordan FJ. The impact of corneal edema on intraocular pressure measurements using goldmann applanation tonometry, Tono-pen XL, iCare, and ORA: an in vitro model. J Glaucoma. 2013;22:584–90.CrossRefPubMed
9.
go back to reference Kass M, Heuer D, Higginbotham E, Johnson C, Keltner J, Miller J, Parrish R, Wilson M, Gordon M. The ocular hypertension treatment study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–13.CrossRefPubMed Kass M, Heuer D, Higginbotham E, Johnson C, Keltner J, Miller J, Parrish R, Wilson M, Gordon M. The ocular hypertension treatment study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–13.CrossRefPubMed
10.
go back to reference Brandt JD, Gordon MO, Gao F, Beiser JA, Phillip J. Adjusting intraocular pressure for central corneal thickness does not improve prediction models for primary open-angle glaucoma. Ophthalmology. 2012;119:437–42.CrossRefPubMed Brandt JD, Gordon MO, Gao F, Beiser JA, Phillip J. Adjusting intraocular pressure for central corneal thickness does not improve prediction models for primary open-angle glaucoma. Ophthalmology. 2012;119:437–42.CrossRefPubMed
11.
go back to reference Feltgen N, Leifert D, Funk J. Correlation between central corneal thickness, applanation tonometry, and direct intracameral IOP readings. Br J Ophthalmol. 2001;85:85–7.CrossRefPubMedPubMedCentral Feltgen N, Leifert D, Funk J. Correlation between central corneal thickness, applanation tonometry, and direct intracameral IOP readings. Br J Ophthalmol. 2001;85:85–7.CrossRefPubMedPubMedCentral
12.
go back to reference Kniestedt C, Nee M, Stamper R. Dynamic contour Tonometry: a comparative study on human cadaver eyes. Arch Ophthalmol. 2004;122:1287–93.CrossRefPubMed Kniestedt C, Nee M, Stamper R. Dynamic contour Tonometry: a comparative study on human cadaver eyes. Arch Ophthalmol. 2004;122:1287–93.CrossRefPubMed
13.
go back to reference Eisenberg D, Sherman B, Mckeown C, Schuman J. Tonometry in adults and children: a manometric evaluation of pneumotonometry, applanation, and tonopen in vitro and in vivo. Ophthalmology. 1998;105:1173–81.CrossRefPubMed Eisenberg D, Sherman B, Mckeown C, Schuman J. Tonometry in adults and children: a manometric evaluation of pneumotonometry, applanation, and tonopen in vitro and in vivo. Ophthalmology. 1998;105:1173–81.CrossRefPubMed
14.
go back to reference Riva I, Quarantra L, Russo A, Katsanos A, Rulli E, Floriani I. Dynamic contour tonometry and Goldmann applanation tonometry: correlation with intracameral assessment of intraocular pressure. Eur J Ophthalmol. 2012;22:55–62.CrossRefPubMed Riva I, Quarantra L, Russo A, Katsanos A, Rulli E, Floriani I. Dynamic contour tonometry and Goldmann applanation tonometry: correlation with intracameral assessment of intraocular pressure. Eur J Ophthalmol. 2012;22:55–62.CrossRefPubMed
15.
go back to reference Tang J, Pan X, Weber P, Liu J. Effect of corneal stiffening on Goldmann Applanation Tonometery and Tonopen measurement in canine eyes. Invest Ophthalmol Vis Sci. 2012;53:1397–405.CrossRefPubMed Tang J, Pan X, Weber P, Liu J. Effect of corneal stiffening on Goldmann Applanation Tonometery and Tonopen measurement in canine eyes. Invest Ophthalmol Vis Sci. 2012;53:1397–405.CrossRefPubMed
16.
go back to reference Arora R, Bellamy H, Austin M. Applanation tonometry: a comparison of the Perkins handheld and Goldmann slit lamp-mounted methods. Clin Ophthalmol. 2014;8:605–10.CrossRefPubMedPubMedCentral Arora R, Bellamy H, Austin M. Applanation tonometry: a comparison of the Perkins handheld and Goldmann slit lamp-mounted methods. Clin Ophthalmol. 2014;8:605–10.CrossRefPubMedPubMedCentral
17.
go back to reference McCafferty S, Lim G, Duncan W, Enikov E, Schwiegerling J. Goldmann Tonometer prism with an optimized error correcting Applanation surface. TVST. 2016;5:1–5.CrossRef McCafferty S, Lim G, Duncan W, Enikov E, Schwiegerling J. Goldmann Tonometer prism with an optimized error correcting Applanation surface. TVST. 2016;5:1–5.CrossRef
18.
go back to reference A-Yong Y, Su-Fang D, Yun-E Z, Xing-Yu L, Fan L, Jianhua W, Qin-Mei W. Correlation between corneal biomechanical properties, applanation tonometry and direct intracameral tonometry. Br J Ophthalmol. 2012;96:640–4.CrossRef A-Yong Y, Su-Fang D, Yun-E Z, Xing-Yu L, Fan L, Jianhua W, Qin-Mei W. Correlation between corneal biomechanical properties, applanation tonometry and direct intracameral tonometry. Br J Ophthalmol. 2012;96:640–4.CrossRef
19.
go back to reference Kohlhaas M, Boehm A, Spoerl E, Pursten A, Grein H, Pillunat L. Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol. 2006;124:471–6.CrossRefPubMed Kohlhaas M, Boehm A, Spoerl E, Pursten A, Grein H, Pillunat L. Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol. 2006;124:471–6.CrossRefPubMed
20.
go back to reference Yeon D, Yoo C, Lee T, Park J, Kim Y. Effects of head elevation on intraocular pressure in healthy subjects: raising bed head vs using multiple pillows. Eye. 2014;28:1328–33.CrossRefPubMedPubMedCentral Yeon D, Yoo C, Lee T, Park J, Kim Y. Effects of head elevation on intraocular pressure in healthy subjects: raising bed head vs using multiple pillows. Eye. 2014;28:1328–33.CrossRefPubMedPubMedCentral
21.
go back to reference Lam A, Wu Y, Wong L, Ho N. IOP variations from sitting to supine postures determined by rebound tonometer. J Opt. 2013;6:95–100.CrossRef Lam A, Wu Y, Wong L, Ho N. IOP variations from sitting to supine postures determined by rebound tonometer. J Opt. 2013;6:95–100.CrossRef
22.
go back to reference Jorge J, Marques R, Lourenco A, Silva S, Nascimento S, Queiros A, Gonzalez-Meijome J. IOP variations in the sitting and supine positions. J Glaucoma. 2010;19:20–31.CrossRef Jorge J, Marques R, Lourenco A, Silva S, Nascimento S, Queiros A, Gonzalez-Meijome J. IOP variations in the sitting and supine positions. J Glaucoma. 2010;19:20–31.CrossRef
23.
go back to reference Davis R, Jiramongkolchai K, Silverstein E, Freedman S. Rebound Tonometry over an air-filled anterior chamber in the supine child after intraocular surgery. J AAPOS. 2016;20:159–64.CrossRefPubMed Davis R, Jiramongkolchai K, Silverstein E, Freedman S. Rebound Tonometry over an air-filled anterior chamber in the supine child after intraocular surgery. J AAPOS. 2016;20:159–64.CrossRefPubMed
Metadata
Title
Goldmann applanation tonometry error relative to true intracameral intraocular pressure in vitro and in vivo
Authors
Sean McCafferty
Jason Levine
Jim Schwiegerling
Eniko T. Enikov
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2017
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-017-0608-y

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