Self-measurement with Icare HOME tonometer, patients’ feasibility and acceptability

2019 ◽  
Vol 30 (2) ◽  
pp. 258-263 ◽  
Author(s):  
Barbara Cvenkel ◽  
Makedonka Atanasovska Velkovska ◽  
Vesna Dimovska Jordanova

Purpose: To evaluate and compare the accuracy of self-measurement of intraocular pressure using Icare Home rebound tonometer with Goldmann applanation tonometer and assess acceptability of self-tonometry in patients with glaucoma and ocular hypertension. Methods: In the study, 117 subjects were trained to use Icare Home for self-measurement. Icare Home tonometer readings were compared with Goldmann applanation tonometer, including one eye per patient. Agreement between the two methods of measurement was evaluated by Bland and Altmann analysis. Questionnaire was used to evaluate patients’ perception of self-tonometry. Results: One hundred and three out of 117 patients (88%) were able to measure their own intraocular pressure and 96 (82%) fulfilled the requirements for certification. The mean (SD) difference Goldmann applanation tonometer minus Icare Home was 1.2 (2.4) mmHg (95% limits of agreement, –3.4 to 5.9 mmHg). The magnitude of bias between the two methods depended on central corneal thickness, with greater bias at central corneal thickness <500 µm. In 65 out of 96 subjects (67.7%), Icare Home results were within 2 mmHg of the Goldmann applanation tonometer. Seventy-three out of 93 (78.5%) felt that self-tonometry was easy to use and 75 patients (80.6%) responded that they would use the device at home. Conclusion: Icare Home tonometry tends to slightly underestimate intraocular pressure compared to Goldmann applanation tonometer. Most patients were able to perform self-tonometry and found it acceptable for home use. Measurements using rebound self-tonometry could improve the quality of intraocular pressure data and optimize treatment regimen.

Author(s):  
Santanu Das ◽  
Nayana Nagesh ◽  
Kiran Kumar L ◽  
Sundeep Shetty

ABSTRACT: AIM-To compare the intraocular pressure (IOP) measured by Non-Contact tonometer (NCT), Rebound tonometer (RBT) and Goldmann Applanation tonometer (GAT) and their correlation with central corneal thickness (CCT), true IOP and corneal curvature. Reliability of each tonometer. METHODS-500 random patients aged 18 years and above were taken up for the study. Patients with anterior and posterior segment pathologies like corneal ulcer, leukoma, staphyloma, corneal lacerations, ectatic corneal conditions, corneal dystrophies, oedema, perforations, acute angle closure glaucoma, retinal detachments, vitreous haemorrhage and unwilling patients were excluded from the study. IOP was recorded using NCT, RBT and GAT after assessing the patient's visual acuity. Following IOP measurement, central corneal thickness (CCT) of each patient was measured using pachymetry. Kvalues were measured using an autorefractometer. All the data were collected and tabulated for statistical analysis to obtain results. RESULTS: The mean CCT in males was 0.5350 mm and in females 0.5340 mm respectively. The mean IOP measured by NCT is 16.43 mm hg whereas the mean IOP measured by GAT is 15.43 mm hg. IOP measured by NCT is significantly higher than the IOP measured by GAT (p<0.001). When NCT and RBT are compared NCT values are significantly higher than that of RBT(p<0.001). Although the mean RBT IOP 15.83 mm hg is higher than the mean GAT IOP of 15.42 mm hg the values are not statistically significant. When correlated with CCT all the tonometers showed significant correlation with GAT showing the strongest correlation. NCT overestimates IOP in normal, thin and thicker corneas when compared to GAT and are statistically significant. RBT also overestimates in the normal and thick corneas when compared to GAT but their values are much closer to GAT values in thinner corneas. The IOP measured by all the 3 tonometers correlated with corrected IOP with NCT showing the best correlation followed by GAT. There was no significant correlation between K and IOP in our study. CONCLUSION-From the present study we can conclude that IOP measured by NCT and RBT is higher than GAT. NCT values are significantly higher than GAT values in thin and normal corneas whereas it overestimates more in thicker corneas. RBT values are significantly higher than that of GAT in normal and thick corneas. All the tonometers show significant correlation with CCT with GAT showing the strongest correlation. So, it is always advisable to measure the corrected IOP for each patient after considering the CCT. Keywords- Non-contact tonometer; Goldmann applanation tonometer; central corneal thickness; intraocular pressure; Rebound tonometer, true IOP, Corneal curvature.  


2020 ◽  
pp. 112067212092138
Author(s):  
Katri Stoor ◽  
Elina Karvonen ◽  
Pasi Ohtonen ◽  
M Johanna Liinamaa ◽  
Ville Saarela

Purpose The aim of this study was to compare the measurements of intraocular pressure by two tonometers, the Icare rebound tonometer and the Goldmann applanation tonometer, in a randomised screening study. The influence of refraction and central corneal thickness on the measurements was also evaluated. Methods Intraocular pressure was measured with rebound tonometer and Goldmann applanation tonometer in 1266 participants; refraction and central corneal thickness were also determined. One randomised eye of each participant was selected for this report’s analysis. A Bland–Altman plot was used to compare the values obtained with the two devices. Results The correlation between rebound tonometer and Goldmann applanation tonometer was good: the intraclass correlation coefficient (r) between the two methods was 0.735 ( p < 0.001). The mean difference (rebound tonometer–Goldmann applanation tonometer) was 0.11 ± 2.3 mmHg. The difference was not statistically significant (95% confidence interval: 0.11 to 0.13, p = 0.09). With increasing central corneal thickness, not only did intraocular pressure values with both devices increase, but the difference between them also increased. Refraction (spherical equivalent) did not influence intraocular pressure or the rebound tonometer–Goldmann applanation tonometer difference. However, high astigmatism (≥2D) exerted an influence on intraocular pressure values taken with Goldmann applanation tonometer. Conclusion Measurements with rebound tonometer and Goldmann applanation tonometer are relatively uniform although rebound tonometer slightly overestimated intraocular pressure. Both rebound tonometer and Goldmann applanation tonometer and the difference between these devices were affected by central corneal thickness but not by refraction. Higher astigmatism affected Goldmann applanation tonometer more than rebound tonometer. It is concluded that rebound tonometer is a reliable method for measuring intraocular pressure in a population-based screening study.


2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Samuel Kyei ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Cynthia Pakyennu Gboglu

BACKGROUND፡ The aim of this study was to determine whether Central Corneal Thickness (CCT) is associated with intraocular pressure measurement (IOP) with a Non-contact tonometer and the Goldmann applanation tonometer in glaucoma patients.MATERIALS AND METHODS: The study involved two hundred and thirty-two eyes of clinically diagnosed glaucoma patients receiving care at a referral facility. IOP measurements were obtained using both the Non-Contact Tonometer (NCT) and Goldmann Applanation Tonometer (GAT). The association between age, ethnicity, and CCT, as well as CCT on the measures of NCT and GAT, were analyzed.RESULTS: There were 64(55.2%) males and 52 (44.8%) females and their ages ranged from 18 to 85 years (mean age = 47.72; SD ±15.75 years). There was a weak positive correlation between the CCT and NCT findings in the right eye (r = 0.19, n = 116, p < 0.05) and in the left eye (r = 0.25, n = 116, p < 0.05). However, there was no correlation between CCT and GAT measurements. Age had a significant correlation with CCT while gender and ethnicity had no significant correlation.CONCLUSION: The study found a significant association between CCT and NCT. However, there was no significant association between CCT and GAT. CCT had an association with age but independent of gender and ethnicity since there was no significant relationship between these variables.


2018 ◽  
Vol 28 (5) ◽  
pp. 582-589
Author(s):  
Sepehr Feizi ◽  
Amir Faramarzi ◽  
Bahareh Kheiri

Purpose: To compare intraocular pressure measured using the Goldmann applanation tonometer with that measured using the ocular response analyzer after congenital cataract surgery. Methods: This study included 113 eyes of 64 patients who underwent lensectomy and vitrectomy. In all, 36 eyes remained aphakic after surgery. Intraocular lens implantation was performed at the time of surgery in 47 eyes and secondarily in 30 eyes. Corneal hysteresis, corneal resistance factor, and cornea-compensated intraocular pressure were measured. The influences of independent factors on the difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer were investigated using linear regression analyses. Agreement between the two tonometers was investigated using the Bland and Altman and 95% limits of agreement analysis. Results: Central corneal thickness, corneal hysteresis, and corneal resistance factor were 591.2 ± 53.3 µm, 10.83 ± 2.27 mmHg, and 11.36 ± 2.14 mmHg, respectively. Cornea-compensated intraocular pressure (16.75 ± 4.82 mmHg) was significantly higher than intraocular pressure measured with Goldmann applanation tonometer (14.41 ± 2.27 mmHg, p < 0.001). Central corneal thickness (p = 0.02) and corneal hysteresis (p < 0.001) were identified as the main predictors of difference between cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer readings. A 95% limits of agreement for cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was between −4.86 and 9.53 mmHg in the entire group. Cornea-compensated intraocular pressure showed the best agreement with intraocular pressure measured with Goldmann applanation tonometer in the primary pseudophakic subgroup as compared to the other subgroups. Conclusion: The Goldmann applanation tonometer and ocular response analyzer cannot be used interchangeably for measuring intraocular pressure after congenital cataract surgery. The difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was primarily affected by central corneal thickness and corneal hysteresis. Among the subgroups, the primary pseudophakic subgroup had the thinnest cornea and the highest corneal hysteresis values and demonstrated the best agreement between the two tonometers.


2011 ◽  
Vol 70 (3) ◽  
Author(s):  
N. Rampersad ◽  
K. P. Mashige ◽  
S. Jhetam

The purpose of this study was to compare the intraocular pressure (IOP) values measured with the Tono-Pachymeter NT530P (Tonopachy™) and the iCare® rebound tonometer (iCare®) with those obtained by the Goldmann applanation tonometer (GAT). The right eyes of 105 subjects aged 18 to 82 years (mean age = 29.27 ± 14.67 years) were assessed with the three tonometers. Central corneal thickness (CCT) was measured first using the Tonopachy™ and then IOP was measured by Tonopachy™, iCare® and GAT. The data was analyzed with descriptive statistics, paired  t-test, correlation and regression analysis. The Bland-Altman method of analysis was used to evaluate agreements between the sets of data from the three devices. The CCT values ranged from 440 µm to 606 µm (mean= 518.49 ± 33.01 µm). There was little or no correlation between CCT and IOP for any of the instruments used in this study (r = 0.29 for Tonopachy™, r = 0.22 for iCare®, r = 0.17 for GAT). The mean IOP measured with the Tonopachy™ was 14.31 ± 3.57 mmHg (range 8.7 mmHg to 31 mmHg) and 16.64 ± 4.38 mmHg (range 8 mmHg to 32 mmHg) using the iCare®. The mean IOP measured with the GAT was 14.79 ± 3.09 mmHg (range 8.7 mmHg to 29.7 mmHg). Using the Bland-Altman method, the upper and lower limits of agreement between the Tonopachy™ and GAT, iCare® and GAT, iCare® and Tonopachy™ were 5.1 mmHg and –4.2 mmHg, 8.6 mmHg and –4.9 mmHg, 7.5 mmHg and –2.8 mmHg respectively. In 79.1% of the eyes studied, the mean IOP difference between Tonopachy™ and GAT was less than 3 mmHg and in 20.9% of the eyes, the difference was greater than 3 mmHg. However, mean IOP differences of greater than 3 mmHg were obtained by iCare® in comparison with GAT (40%) and Tonopachy™ (34.3%) respectively. Findings of this study suggest that the Tonopachy™ yielded IOP readings that were consistent with those of GAT values while iCare® yielded higher IOP values compared to both GAT and Tonopachy™. (S Afr Optom 2011 70(3) 109-116)


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