Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas

Purpose: To investigate in vitro the accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas. Methods: Experimental study included 20 freshly enucleated porcine eyes. Epithelium was debrided, and eyes were divided in four groups. Groups were immers...

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Main Authors: George A. Kontadakis, Alexandros Pennos, Iro Pentari, George D. Kymionis, Ioannis G. Pallikaris, Harilaos Ginis
Format: Article
Language:English
Published: SAGE Publishing 2020-06-01
Series:Therapeutic Advances in Ophthalmology
Online Access:https://doi.org/10.1177/2515841420923190
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author George A. Kontadakis
Alexandros Pennos
Iro Pentari
George D. Kymionis
Ioannis G. Pallikaris
Harilaos Ginis
author_facet George A. Kontadakis
Alexandros Pennos
Iro Pentari
George D. Kymionis
Ioannis G. Pallikaris
Harilaos Ginis
author_sort George A. Kontadakis
collection DOAJ
description Purpose: To investigate in vitro the accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas. Methods: Experimental study included 20 freshly enucleated porcine eyes. Epithelium was debrided, and eyes were divided in four groups. Groups were immersed in 35%, 40%, 50%, and 60% glycerin solutions for 3 hours. Subsequently, globes were mounted in a special holder, and their intraocular pressure was hydrostatically adjusted. Intraocular pressure was measured by means of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL while adjusting true intraocular pressure to 17, 33, and 50 mm Hg. Ultrasound pachymetry was performed. Results: Mean corneal thickness was 914.5 ± 33.3 μm (730–1015 μm). In true intraocular pressure of 33 mm Hg, Goldmann applanation tonometry and dynamic contour tonometry significantly underestimated true intraocular pressure (mean Goldmann applanation tonometry: 14.7 ± 4.8 mm Hg, p  < 0.001, mean dynamic contour tonometry: 21.6 ± 6.8, p  < 0.001). Tono-Pen XL also underestimated, but difference was not statistically significant (Tono-Pen XL: 27.9 ± 9.7, p  = 0.064). In true intraocular pressure of 50 mm Hg, all three methods significantly underestimated (Goldmann applanation tonometry: 17.6 ± 5.3 mm Hg, p  < 0.001, dynamic contour tonometry: 26.8 ± 6.3 mm Hg, p  < 0.001, Tono-Pen XL: 35.6 ± 8.4 mm Hg, p  < 0.001). The error in measured intraocular pressure for each method (true minus measured intraocular pressure) was significantly correlated to true intraocular pressure ( p  < 0.001). The intraocular pressure measurements of each eye taken under true intraocular pressure of 17 and 33 mm Hg with the three methods were correlated to each other. Measurements taken under intraocular pressure of 50 mmHg were not correlated to each other. Corneal thickness was not correlated to intraocular pressure measurement. Conclusion: Goldmann applanation tonometry, dynamic contour tonometry, and Tono-Pen XL underestimate intraocular pressure when measured under edematous conditions. Tono-Pen XL showed better accuracy, especially in lower true intraocular pressure. The measurement error increases when true intraocular pressure increases in all three methods.
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spelling doaj.art-7cfaefbc3a4844cb91985ea85eb1ce872022-12-22T01:08:17ZengSAGE PublishingTherapeutic Advances in Ophthalmology2515-84142020-06-011210.1177/2515841420923190Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneasGeorge A. KontadakisAlexandros PennosIro PentariGeorge D. KymionisIoannis G. PallikarisHarilaos GinisPurpose: To investigate in vitro the accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas. Methods: Experimental study included 20 freshly enucleated porcine eyes. Epithelium was debrided, and eyes were divided in four groups. Groups were immersed in 35%, 40%, 50%, and 60% glycerin solutions for 3 hours. Subsequently, globes were mounted in a special holder, and their intraocular pressure was hydrostatically adjusted. Intraocular pressure was measured by means of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL while adjusting true intraocular pressure to 17, 33, and 50 mm Hg. Ultrasound pachymetry was performed. Results: Mean corneal thickness was 914.5 ± 33.3 μm (730–1015 μm). In true intraocular pressure of 33 mm Hg, Goldmann applanation tonometry and dynamic contour tonometry significantly underestimated true intraocular pressure (mean Goldmann applanation tonometry: 14.7 ± 4.8 mm Hg, p  < 0.001, mean dynamic contour tonometry: 21.6 ± 6.8, p  < 0.001). Tono-Pen XL also underestimated, but difference was not statistically significant (Tono-Pen XL: 27.9 ± 9.7, p  = 0.064). In true intraocular pressure of 50 mm Hg, all three methods significantly underestimated (Goldmann applanation tonometry: 17.6 ± 5.3 mm Hg, p  < 0.001, dynamic contour tonometry: 26.8 ± 6.3 mm Hg, p  < 0.001, Tono-Pen XL: 35.6 ± 8.4 mm Hg, p  < 0.001). The error in measured intraocular pressure for each method (true minus measured intraocular pressure) was significantly correlated to true intraocular pressure ( p  < 0.001). The intraocular pressure measurements of each eye taken under true intraocular pressure of 17 and 33 mm Hg with the three methods were correlated to each other. Measurements taken under intraocular pressure of 50 mmHg were not correlated to each other. Corneal thickness was not correlated to intraocular pressure measurement. Conclusion: Goldmann applanation tonometry, dynamic contour tonometry, and Tono-Pen XL underestimate intraocular pressure when measured under edematous conditions. Tono-Pen XL showed better accuracy, especially in lower true intraocular pressure. The measurement error increases when true intraocular pressure increases in all three methods.https://doi.org/10.1177/2515841420923190
spellingShingle George A. Kontadakis
Alexandros Pennos
Iro Pentari
George D. Kymionis
Ioannis G. Pallikaris
Harilaos Ginis
Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
Therapeutic Advances in Ophthalmology
title Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
title_full Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
title_fullStr Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
title_full_unstemmed Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
title_short Accuracy of dynamic contour tonometry, Goldmann applanation tonometry, and Tono-Pen XL in edematous corneas
title_sort accuracy of dynamic contour tonometry goldmann applanation tonometry and tono pen xl in edematous corneas
url https://doi.org/10.1177/2515841420923190
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