不同眼压计类型和测量体位对青光眼眼压测量值的影响

Influences of the tonometer type and posture on IOP measurement

目的比较压平眼压计和非接触眼压计在坐位和卧位时测得的眼压值,探讨眼压计类型和测量体位对青光眼眼压值的影响。方法对28例原发性开角型青光眼患者进行日间眼压曲线测量,测量时间分别为9:30、11:30、13:30、15:30。先在卧位下使用压平眼压计进行测量,然后在坐位下分别使用压平和非接触眼压计进行测量。采用方差分析比较不同时间点、不同测量方法所获得的眼压值。结果卧位压平、坐位压平及坐位非接触眼压计测得的眼压平均值分别为(24.47±10.35)、(21.95±9.73)、(18.37±8.18)mmHg。当非接触眼压在10～20mmHg时,坐位压平眼压较非接触眼压高1.9～3.9mmHg,卧位压平眼压较非接触眼压高3.0～6.4mmHg。3种测量方法测得的峰值眼压超过21mmHg的患者分别为20、14、10例,使用非接触眼压计可能漏诊50%眼压失控的患者。结论使用压平眼压计和非接触眼压计及不同测量体位会对眼压值产生不同的影响,使用非接触眼压计不能对眼压是否正常作出准确的判断,尤其是当眼压处于靶眼压附近时。

Objective Research showed that the different tonometer and posture of patients have obvious influence on the measuring value of intraocular pressure（ IOP）. This paper was to discuss the influences of different tonometer in the different body posture on the judgment of intraocular pressue （IOP） readings in patients with primary open angle glaucoma（POAG）. Methods The diurnal IOP was measured in 9：30,11：30,13：30 and 15：30 using applanation tonometer（AT） in both sitting and supine position and using non-contact tonometer（NCT） only in sitting position. IOP curve was drawn in 28 patients with POAG. The IOP readings measured by different tonometer and posture in various time points were compared. Results The supine IOP readings by AT were significantly higher than those of NCT in various time points（ P 〈 0.05）. The peak IOP value from supine and sitting posture by AT and by NCT was 26.82±10. 65 mmHg,24.00± 10. 10 mmHg and 20. 25 ± 8.71 mmHg respectively. The peak supine IOP value by AT was over 21 mmHg in 20 patients,and that of the sitting posture by AT was in 14 patients and only 10 patients by NCT. The sensitivity of NCT in measuring IOP was only 50%. Conclusion The tonometer and body posture of patients with POAG in measuring IOP have certain influence on the IOP readings. The IOP value from NCT has the limiting accuracy.