Comparison of intraocular pressure measurements with different contact tonometers in young healthy persons

AIM：To analyze the correlation of Goldmann applanation tonometer（GAT）,I-Care tonometer and Tono-Pen tonometer results in young healthy persons,and to investigate the influence of central corneal thickness（CCT）on intraocular pressure（IOP）measurements recorded with these tonometers.·M ETHODS：We conducted a pilot clinical study in 78eyes of 78 subjects aged 22-28 years old（44 women and34 men;mean age 23.8±1.19y）.IOP was measured using GAT,I-Care and Tono-Pen tonometers,followed by measurements of CCT.Statistical analysis was performed using SPSS 20.0.·RESULTS：The mean IOPs and standard deviation（±SD）for GAT,I-Care and Tono-Pen were 15.62±2.281 mm Hg,16.29±2.726 mm Hg and 16.32±2.393 mm Hg,respectively.The mean CCT was 555.15±29.648μm.Clear positive correlations between GAT and I-Care,GAT and TonoPen,and I-Care and Tono-Pen tonometers were found（=0.867,〈0.001;=0.861,〈0.001;=0.915,〈0.001,respectively）.In comparison between devices,BlandAltman analysis showed a significant mean difference（MD）in the measurements by GAT and I-Care of-0.679 mm Hg and by GAT and Tono-Pen of-0.705 mm Hg（〈0.001）,but there was no significant difference between I-Care and Tono-Pe（〉0.05）.Both non-gold standard tonometers were affected by CCT;that is,both I-Care and Tono-Pen tonometer values were significantly higher with higher CCT means（〉555μm;MD=-1.282,〈0.001;MD=-0.949,〈0.001,respectively）compared with GAT.·CONCLUSION：Both I-Care and Tono-Pen tonometers overestimated IOP compared with the GAT values.Either the I-Care or Tono-Pen tonometer could be used instead of GAT because there was no significant difference between their results.Higher CCT values（〉555μm）were associated with overestimated IOP values.

Impact of corneal parameters on intraocular pressure measurements in different tonometry methods

AIM: To evaluate the impact of central corneal thickness(CCT) and corneal curvature on intraocular pressure(IOP) measurements performed by three different tonometers. METHODS: IOP in 132 healthy eyes of 66 participants was measured using three different tonometry techniques: Goldmann applanation tonometer(GAT), Pascal dynamic contour tonometer(DCT), and ICare rebound tonometer(RT). CCT and corneal curvature were assessed. RESULTS: In healthy eyes, DCT presents significantly higher values of IOP than GAT(17.34±3.69 and 15.27±4.06 mm Hg, P<0.0001). RT measurements are significantly lower than GAT(13.56±4.33 mm Hg, P<0.0001). Compared with GAT, DCT presented on average 2.51 mm Hg higher values in eyes with CCT<600 μm and 0.99 mm Hg higher results in eyes with CCT≥600 μm. The RT results were lower on average by 1.61 and 1.95 mm Hg than those obtained by GAT, respectively. Positive correlations between CCT in eyes with CCT<600 μm were detected for all IOP measurement techniques, whereas a similar relationship was not observed in eyes with thicker corneas. A correlation between IOP values and keratometry in the group with CCT<600 μm was not detected with any of the tonometry methods. In thicker corneas, a positive correlation was found for GAT and mean keratometry values(R=0.369, P=0.005). CONCLUSION: The same method should always be chosen for routine IOP control, and measurements obtained by different methods cannot be compared. All analysed tonometry methods are dependent on CCT;thus, CCT should be taken into consideration for both diagnostics and monitoring.

Comparison among Ocular Response Analyzer,Corvis ST and Goldmann applanation tonometry in healthy children

AIM： To explore the relationship between different parameters of Ocular Response Analyzer（ORA） and Corvis ST（CST） in a sample of healthy Iranian school-aged children and the relationship between parameters of these 2 instruments against intraocular pressure（IOP）, measured by the Goldmann applanation tonometer（GAT-IOP）, age and gender, and find possible correlation between ORA and CST with GAT.METHODS： This cross-sectional study included 90 healthy children. A general interview and complete eye examination were performed. Following successful GATIOP measurement, ORA and CST were conducted. The CST parameters were A 1/2 length（A1 L, A2 L）, A 1/2 velocity（A1 V, A2 V）, highest concavity deformation amplitude（HCDA）, radius of curvature（Ro C）, peak distance（PD）, central corneal thickness（CCT） and IOP. The ORA parameters were corneal hysteresis（CH）, corneal resistance factor（CRF）, Goldmann-correlated IOP（IOP-G） and corneal compensated IOP（IOP-CC）. Extracted data was analyzed using the Statistical Package for Social Science software.RESULTS： Totally 39 males with age of 9.08±1.60（6-12）y and 51 females with age of 8.96±1.55（6-13）y were included. Many CST parameters were significantly correlated with CH, CRF, IOP-G and IOP-CC. Some CST parameters had a significant correlation with GAT-IOP, including IOP-CST in both eyes and HCDA, A2 L, PD, and RoC in the left eye, but none with age, except A2 L in the right eye. The CRF measurement showed a significant correlation with GAT-IOP in both eyes and CH in the right eye, yet, none with age. Among all CST and ORA parameters, CCT-CST in both eyes and A1 L in right eye had a significant correlation with gender, although this was a negligible negative correlation. Comparison of mean IOP values by different devices showed a significantly highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Also, IOP-G versus IOP-CST significantly had the lowest IOP overestimation among others. Overall, either low positive correlation or negligible correlation was found between IOP measurements by 3 instruments.CONCLUSION： The study finds the highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Overall, either low positive correlation or negligible correlation is found between IOP measurements by the 3 instruments.

Intraocular pressure measurement over soft contact lens by rebound tonometer: a comparative study

AIM: To evaluate the intraocular pressure(IOP)measurements by Icare rebound tonometer over a contact lens in comparison with Goldmann applanation tonometry(GAT). METHODS: Fifty patients using contact lens were included in this study. One of the eyes of the patients was selected randomly and their IOP were measured by rebound tonometer with and without contact lens(RTCL,RT respectively) and by GAT, as well as their central corneal thickness(CCT) by optical pachymeter. The results of both methods were compared by correlation analysis, general linear method repeated measure and Bland-Altman analysis.RESULTS: Mean IOP values measured by RTCL, RT and GAT were 15.68 ±3.7, 14.50 ±3.4 and 14.16 ±2.8(P 【0.001), respectively. Mean IOP by RTCL was significantly higher than the measurements implemented by RT and GAT(P 【0.001), while there was no difference between the measurements by GAT and RT(P =0.629). There was a good level of positive correlation between GAT and RTCL as well as RT(r =0.786 P 【0.001, r =0.833 P 【0.001, respectively). We have observed that CCT increase did not show any correlation with the differences of the measurements between RTCL and RT(P =0.329), RTCL and GAT(P =0.07) as well as RT and GAT(P =0.189) in linear regression model.CONCLUSION: The average of the measurements over contact lens by rebound tonometer was found to be higher than what was measured by GAT. Although this difference is statistically significant, it may be clinically negligible in the normal population.

Rebound Tonometry in Cataract Surgery: Comparison with Goldmann Applanation Tonometry

Purpose: to compare the rebound tonometer ICare? (RT) with the Goldmann applanation tonometer (GAT) in cataract surgery and to assess the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements. Design: retrospective, comparative study. Methods: a total of 472 patients underwent IOP measurement using RT (time 0 = RTa). GAT IOP measurement was performed 5 minutes later, followed by a second RT IOP measurement after other 5 minutes (RTa + 10 min = RTb). CCT was obtained by ultrasound pachymetry. In 106 patients IOP was measured by means of RT and GAT before clear corneal cataract surgery (RT1 and GAT1) and at one day postoperatively (RT2 and GAT2). Results: RT IOP values > 5 mmHg were overestimated, while RT IOP values Conclusion: our results showed a good agreement between measurements obtained with RT and GAT in pre and postoperative cataract surgery, although a significant statistically difference was found between RT and GAT measurements performed postoperatively. Moreover, CCT is a parameter to be considered for the IOP measurement, especially for values obtained with RT.

Agreement of intraocular pressure measurement with Corvis ST,non-contact tonometer,and Goldmann applanation tonometer in children with ocular hypertension and related factors

AIM:To access the agreement of intraocular pressure(IOP)values obtained from biomechanically corrected tonometer[Corvis ST(CST)],non-contact tonometer(NCT),and Goldmann applanation tonometer(GAT)in children with NCT measured-IOP(NCT-IOP)values of 22 mm Hg or more,and related factors.METHODS:A total of 51 eyes with NCT-IOP≥22 mm Hg in children aged 7 to 14y were examined and IOP was measured by CST,NCT,and GAT.Based on GAT measured IOP(GAT-IOP),ocular hypertension(OHT)group(≥22 mm Hg,24 eyes)and the non-OHT group(<22 mm Hg,27 eyes)were defined.We compared the agreement of the three measurements,i.e.,CST measured IOP(CST-IOP),GAT-IOP,and NCT-IOP,and further analyzed the correlation between the differences in tonometry readings,central corneal thickness(CCT),axial length(AL),optic disc rim volume,and age.RESULTS:Compared with the OHT group,thicker CCT,larger rim volume,and higher differences between NCTIOP and GAT-IOP,were found in the non-OHT group.The differences between CST-IOP and GAT-IOP were lower than the differences between NCT-IOP and GAT-IOP in both groups.The mean differences in CST-IOP and GAT-IOP were 1.26 mm Hg(95%limit of agreement ranged from 0.1 to 2.41 mm Hg,OHT group)and 1.20 mm Hg(95%limit of agreement ranged from-0.5 to 3.00 mm Hg,non-OHT group),and the mean differences in NCT and GAT were 3.90 mm Hg(95%limit of agreement ranged from-0.19 to 9.70 mm Hg,OHT group)and 6.00 mm Hg(95%limit of agreement ranged from 1.50 to 10.50 mm Hg,non-OHT group).The differences between CST-IOP and GAT-IOP were not related to CCT,age,and AL in both groups;while the differences between NCT-IOP and GAT-IOP were related to CCT in the OHT group(r=0.93,P<0.001)and to CCT and AL in the non-OHT group(r=0.66,P<0.001,r=-0.81,P<0.001).CONCLUSION:The accuracy of NCT in the diagnosis of pediatric OHT is low.The agreement of CST-IOP and GATIOP was significantly higher in children with and without OHT than in those with NCT-IOP and GAT-IOP.Therefore,CST can be used as a good alternative for IOP measurement in children.The impacts of CCT and AL on NCT measurement need to be fully considered when managing childhood IOP.

可贴敷型压力传感器在眼压测量的可行性应用研究

为解决传统非接触式眼压计(Non-contact Tonometer, NCT)在眼压测量过程中患者体验感差、无法连续监测眼压等问题,将可贴敷型压力传感器模拟“指拭”测量法用于眼压测量。本文选用了型号为ZE120-05AA的可贴敷型压力传感器(灵敏度10 Pa),对门诊569例患者进行了眼压测量,并与非接触式眼压计所测数据进行对比研究。采用皮尔森相关性数据分析方法,发现两组检测数据呈现一定的相关性(r=0.96,P<0.001),两组数据线性拟合的斜率分别为0.068(NCT)和0.079(可贴敷型压力传感器)。结果表明可贴敷型压力传感器在眼压测量方面满足眼压测量的准确性和可靠性,在眼压临床检测应用方面是可行的。

Transpalpebral Diaton眼压计与非接触式眼压计测量眼压的差异及影响因素研究

目的：比较Transpalpebral Diaton 眼压计（TDT）与非接触式眼压计（NCT）在正常人群中眼压测量值的差异，探讨影响两种眼压计测量值的因素。方法选择2014年4—7月南昌大学第一附属医院眼科门诊就诊的眼压在正常范围内的非青光眼患者100例（200只眼），将患者按照就诊顺序分为A组和B组，各50例。 A组采用TDT测量眼压， B组采用NCT测量眼压。同时检查裸眼视力、角膜曲率、屈光度、角膜中央厚度（CCT）、眼轴、散光度及泪膜四项〔泪膜破裂时间（ BUT）、角膜荧光素染色（ FL）、基础泪液分泌试验（ SIT）及泪河高度〕。结果两组裸眼视力、角膜曲率、屈光度、 CCT、眼轴、散光度及泪膜四项检查指标比较，差异均无统计学意义（ P＞0.05）。 A组眼压、左眼眼压、右眼眼压均低于B组（P＜0.05）。两组CCT＜500μm者眼压比较，差异无统计学意义（P＞0.05）； A组CCT 500～550μm者和＞550μm者眼压均低于B组（P＜0.05）。 A组眼压与年龄呈正相关（P＜0.05）； B组眼压与年龄呈正相关，与CCT、散光度呈负相关（ P＜0.05）。直线回归结果显示，年龄是影响TDT眼压计测量值的因素（ P＜0.05）；年龄、 CCT、散光度是影响NCT眼压计测量值的因素（ P＜0.05）。结论 TDT测量值比NCT测量值偏低，且受年龄影响，与CCT和散光度无关。

非接触式眼压计与Goldmann压平眼压计测量眼压的比较

目的:比较非接触眼压计(non-contacttonometer,NCT)与Goldmann压平眼压计(GAT)测量眼压的差异,以评价非接触式眼压计在临床青光眼患者及疑似青光眼患者中的的应用价值。方法:志愿者174例348眼分别由专人进行非接触眼压计(NCT)与Goldmann压平眼压计眼压测量。结果:非接触眼压计(NCT)的测量结果低于Gold-mann压平眼压计且差异有显著性(19.6vs23.4,P<0.05),两者相关系数为r=0.783,差异在眼压>30mmHg组更为明显,相关系数为0.334。结论:非接触眼压计(NCT)可以用于临床普查,在青光眼的临床工作中建议使用Goldmann压平眼压计矫正。

Goldmann压平眼压计与非接触式眼压计测量眼压的对比研究(英文)

目的:比较Goldmann压平眼压计(Goldmannapplanationtonometer,GAT)与非接触眼压计(non-contacttonometer,NCT)测量眼压的差异,以评价NCT与GAT测量的相关性。方法:对265例志愿者(529眼)分别采用Goldmann压平眼压计与非接触眼压计测量眼压。结果:非接触眼压计的测量结果低于Goldmann压平眼压计,且差异有显著性(19.13vs23.43,t=22.644,P<0.01),随眼压值的升高,两者相差幅度增大,差异在眼压〉30mmHg时更为明显,但相关系数逐渐变小。结论:非接触眼压计眼压测量值较Goldmann眼压测量值偏低,非接触眼压计眼压值为临界眼压时,需应用Gold-mann压平眼压计校正,以便及时发现病理性眼压升高,避免青光眼的漏诊和失治。

iCare回弹式眼压计测量的重复性及与Goldmann压平式眼压计测量值间的一致性研究

背景Goldmann压平式眼压计（GAT）是眼压测量的金标准，但由于操作复杂且需要良好配合而影响其临床应用。iCare回弹式眼压计（RBT）是一种新型的压平式眼压计，但需进行充分的临床应用评价。目的对iCareRBT检查者间及检查者内测量的可重复性及iCareRBT与GAT测量值间的一致性进行研究。方法2位操作者使用iCareRBT对36例青光眼及可疑青光眼患者双眼各测量1次，分别记录读数，对iCareRBT检查者间的重复性进行评价。2位操作者使用iCareRBT分别测量56例青光眼和52例青光眼患者，并对可疑青光眼患者的双眼进行测量，并记录眼压读数，对iCareRBT检查者内的重复性进行评价。检查者2对青光眼及可疑青光眼患者92例182眼先使用iCareRBT进行测量，然后检查者1使用Goldmann压平式眼压计进行测量，对iCareRBT和GAT的测量值进行一致性检验，并评价iCareRBT测量眼压的安全性。结果iCareRBT检查者间眼压测量值相关因子r右眼为0．937，左眼为0．887；检查者1对右眼和左眼重复测量眼压值的r值分别为0．986、0．969，检查者2所测右眼和左眼的r值分别为0．990、0．979；iCareRBT测量值与CAT测量值的均值分别为（18．74±8．36）mmHg、（19．33±8．20）mmHg，二者差值为（-0．59±2．60）mmHg，95％CI为（-5．80～4．60），2种测量法相关因子r为0．951。所有受试者对iCareRBT的测量无不适反应。结论iCareRBT具有检查者间和检查者内的高度可重复性及很好的耐受性，iCareRBT测量值与GAT测量值间具有高度相关性。

非接触式眼压计与Goldmann压平眼压计测量眼压值一致性的Meta分析

背景非接触式眼压计（NCT）是临床常见的眼压测量设备，其测量值受角膜参数等多种因素的影响，近年有ll缶床研究针对NCT与“金标准”Goldmann眼压计（GAT）测量眼压值一致性的报道，但尚缺乏循证评价。目的从循证医学的角度评价NCT与GAT测量眼压值的一致性。方法采用严密制定的检索策略检索MEDLINE、EMbase、中国生物医学文献数据库、中国期刊全文数据库文献，检索年限为从各数据库建库至2016年6月。按照纳入和排除标准筛选文献，提取样本量、平均年龄、样本特征、随访时间、NCT与GAT眼压测量等数据。使用Cochrane协作网提供的Review Manager5．3．0软件进行合并效应量的检测，6篇文献间经，。检验存在异质性，采用随机效应模型校正后对NCT与GAT测量的眼压值进行分析。结果初步检索共获得24篇文献，筛选后共纳入NCT与GAT测量眼压值的比较研究6篇，总样本量为478眼。采用随机效应模型校正后，NCT的眼压测量值较GAT眼压测量值高0．02mmHg（1mmHg=0．133kPa），差异无统计学意义[加权均数差（WMD）=0．02，95％可信区间（CI）：-0．59～0．63，P=0．95]。漏斗图法显示文献存在发表偏倚。结论NCT与GAT测量正常人群眼压结果具有较好的一致性，但尚需更多大样本比较研究提供支持。

Transpalpebral diaton眼压计在闭角性青光眼患者的应用研究

目的比较Transpalpebral Diaton眼压计(TDT)与非接触式眼压计(NCT)在闭角性青光眼患者中测量值的差异,并观察比较年龄、角膜曲率、屈光度、CCT、眼轴、散光度数对两种眼压计的影响。方法前瞻性临床对比研究。按就诊次序随机选取80例(80只眼)门诊闭角性青光眼患者行TDT(A组)和NCT测量(B组)。同时检查患者视力、角膜曲率、屈光度数、CCT、眼轴、前房角、散光度数、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、基础泪液分泌试验(ST)及泪河高度测量等检查。结果两组患者裸眼视力、角膜曲率、屈光度、CCT、眼轴、散光度数比较差异无统计学意义(P>0.05)。A、B两组按角膜中央厚度分为3组,B组在不同年龄间测量值差异有统计学意义(F=8.934,P<0.05),而A组测量值在此3组间差异无统计学意义(F=0.442,P>0.05),TDT与N CT眼压计测量的眼压平均值分别为(36.93±8.93)mm Hg和(38.12±9.42)mm Hg;两种测量方式的测量值显著相关,Pearson相关系数r=0.993,P<0.05;Bland-Altman分析显示两种眼压计的测量值具有很好的一致性,测量值之差为(1.194±1.054)。两种眼压计测量值与年龄呈正相关(P<0.05),NCT测量值与CCT、散光度数有关(P<0.05)。结论闭角性青光眼患者TDT测量值比N CT测量平均值偏低,且受年龄的影响,与CCT和散光度无关。

iCare回弹式眼压计与Goldmann压平眼压计测量结果的比较

目的对比iCare回弹式眼压计(RBT)与Goldmann压平眼压计(GAT)测量眼压的一致性,评价RBT测量眼压的准确性及安全性。方法研究为诊断性试验评价。分别用2种眼压计测量角膜正常的患者52例104眼,其中男28例,女24例;年龄19～76岁,以GAT眼压值作为基准分为5组:≤10mmHg、11～20mmHg、21～30mmHg、31～40mmHg、≥41mmHg组。评估2种测量方法的眼压值差值及其与眼压的关系。对RBT眼压值随GAT眼压值变化的关系进行评价。结果 RBT测得的眼压读数为(17.20±9.13)mmHg,GAT测得的眼压读数为(17.13±8.94)mmHg,二者差异无统计学意义(t=0.260,P=0.795)。60.58%的患者2种方法测得的眼压差值在1mmHg以内。5个组中,GAT眼压与RBT眼压的绝对差值随着眼压读数的增高而加大,最大值在≥41mmHg组,二者的最大绝对差值<4mmHg。RBT眼压读数随着GAT眼压读数的改变而变化,二者的变化呈现良好的相关性(r=0.917,P<0.01),但与GAT测量法比较,RBT测得的眼压值均稍高。当GAT眼压值>21mmHg时,RBT测量的敏感度和特异度分别为95.5%和98.8%。RBT测量后25%的患者主诉有异物感和眼干。结论 iCareRBT测量眼压具有良好的耐受性和安全性,与GAT测量眼压具有较好的相关性,适用于临床。

可视化角膜生物力学分析仪与非接触眼压计和动态轮廓眼压计测量眼内压的一致性研究

目的 探讨可视化角膜生物力学分析仪（corneal visualization scheimpflug technology,Corvis ST）测量眼内压（intraocular pressure,IOP）的重复性,及与非接触眼压计（non-contact tonometr,NCT）和动态轮廓眼压计（dynamic contour tonometry,DCT）测量结果的一致性。方法 选取正常角膜志愿者91例（91眼）。分别应用Corvis ST,NCT和DCT进行眼内压测量,每种仪器测量3次。采用单因素方差分析比较3种不同眼压计测量的IOP结果,组内相关系数（intraclass correlation coefficient,ICC）评估3种仪器各自测量眼内压的可重复性;Bland-Altman分析比较3种仪器测量IOP的一致性;Pearson双变量相关分析眼压测量结果间的相关性。结果 IOPCor、IOPNCT和IOPDCT的均值分别为（13.39±2.48）mm Hg（1 mm Hg=0.133 k Pa）,（13.94±2.32）mm Hg和（17.26±2.00）mm Hg,差异有统计学意义（F=76.949,P〈0.001）。相关性分析显示,3种测量仪器所测眼压结果存在明显相关性（P均〈0.001）。IOPCor、IOPNCT和IOPDCT科隆巴赫系数（Cronbach＇sα）分别为0.94、0.91和0.94;组内相关系数ICC分别为0.83、0.76和0.83。Bland-Altman一致性分析显示,组内偏差,IOPCor与IOPNCT为（-0.5±1.8）mm Hg;IOPCor与IOPDCT为（-3.9±2.1）mm Hg;IOPDCT与IOPNCT为（-3.3±2.2）mm Hg,其一致性界限区间分别为（-4.1~3.0）mm Hg、（-7.9~0.2）mm Hg和（-7.6~1.0）mm Hg。结论 Corvis ST能够有效测量眼内压且测量重复性好,与NCT测量结果具有较好的一致性,但与DCT测量结果存在差异。

Tono-pen眼压计的可重复性和准确性研究

目的通过比较反复测量所得的眼压值,了解Tono-pen眼压计测量眼压的可重复性和准确性。方法选取眼科门诊就诊的84例患者和健康体检者2名共150眼纳入研究。由2名检查者先后用Tono-pen眼压计和Goldmann眼压计进行3次连续测量。按照Goldmann眼压计测量值从低到高将研究对象分为A、B、C3组：A组（低眼压组）IOP〈11mmHg（1kPa=7.5mmHg）,B组（正常眼压组）IOP为11~21mmHg,C组（高眼压组）IOP〉21mmHg。分组分析Tono-pen眼压计组内（检查者甲3次测量值之间）可重复性和组间（2名检查者之间）可重复性。以Goldmann眼压计为标准评价Tono-pen眼压计的准确性。结果组内可重复性：Tono-pen眼压计反复测量差值平均值A组（1.533±1.008）mmHg,B组（1.673±1.123）mmHg,C组（3.474±2.695）mmHg。组间可重复性：以2名检查者的测量平均值进行比较。Tono-pen眼压计组间相差范围：A组0.25~1.77mmHg,B组0.40~0.73mmHg,C组0.07~0.83mmHg。与Gold-mann眼压计测量值比较,A组Tono-pen眼压计平均偏低估计眼压0.87mmHg（0.02~1.71mmHg,P=0.045）,B组2种测量手段所得结果无差异（P=0.845）,C组Tono-pen眼压计平均偏低估计眼压5.76mmHg（2.30~9.21mmHg,P=0.003）。结论对于正常眼压范围的个体,Tono-pen眼压计测量值与Goldmann眼压计测量值相当,但对于低眼压或高眼压眼,Tono-pen眼压计测量值均比Goldmann眼压计测量值偏低。

ICare回弹式眼压计与NCT测量结果的比较

目的:比较ICare回弹式眼压计(ICareRBT)和非接触眼压计(NCT)测量值的一致性,评价ICareRBT的测量精确性。方法:对113例222眼(右眼111眼,左眼111眼)随机使用NCT和ICare回弹式眼压计测量眼压,对两种眼压计所测眼压值的差异采用配对t检验分析法,对ICare所测眼压值随NCT所测值变化的关系分析采用线性回归分析法,对ICare与NCT眼压测量值的一致性采用Bland-Altman分析法。结果:使用ICareRBT和NCT测得的眼压均值分别为18.46±8.50mmHg和17.09±8.32mmHg,二者差值为1.36±1.52mmHg,两种测量方法Pearson相关因子r为0.984。Bland-Altman分析证实ICareRBT与NCT眼压测量值具有良好的一致性。所有受试者对ICareRBT的测量无不适反应。结论:ICareRBT与NCT测量值间具有高度的相关性,可以作为可靠的筛查工具,并可以在临床广泛应用。

PASCAL动态轮廓眼压计临床应用的初步报告

目的:验证动态轮廓眼压计(DCT)的临床性能。方法:对81例143眼青光眼及可疑病例青光眼患者用DCT测量眼内压(IOP);132眼同时用Goldmann压平眼压计(GAT)测量眼压,部分病例同时用NIDEKUP-1000型角膜测厚仪测量中央角膜厚度(CCT)。GAT与DCT测量结果采用配对t检验,GAT、DCT测量值与CCT的关系及DCT测量值与眼脉动振幅(OPA)的相关关系采用Spearman双变量相关分析。结果:①DCT和GAT测得的眼压均数分别为(18.6±3.9)mmHg和(17.4±4.1)mmHg;DCT测得的眼压值高于GAT,其差值均数为(1.1±2.3)mmHg;两种眼压计测得的眼压值呈正相关(r=0.83,P<0.01)。②116眼同时完成了DCT眼压测量及CCT测量,两者相关系数r=0.03,P=0.77;113眼同时完成了GAT眼压测量及CCT测量,两者相关系数r=0.28,P=0.003。③143眼同时记录了DCT眼压值和眼脉动振幅(OPA),其均数分别为(18.6±3.9)mmHg和(2.6±1.1)mmHg,两者的相关系数r=0.32,P<0.01。结论:以上结果初步证实:①DCT眼压计测量值与GAT眼压测量值高度相关,但DCT测量值略高于GAT测量值,提示DCT可用于临床诊断。②DCT测量值与CCT不相关,GAT测量值与CCT显著相关,提示DCT在青光眼诊断中有独特优势。③DCT测量的OPA与IOP值显著相关,相关的机制及临床意义有待探讨。

家兔眼压测量的标定问题

应用兔眼接压力传感器记录眼内压，通过一灌注系统改变眼内压，用Ｓｃｈｉｏｔｚ和Ｐｅｒｋｉｎｓ眼压计进行眼压测量，对此二种眼压计进行标定。结果发现家兔眼球壁硬度平均值为０．００３２±０．００１１，远较人眼为低，所以用Ｓｃｈｉｏｔｚ眼压计必须用双砝码测量对读才能避免实验性研究的误差；也发现Ｐｅｒｋｉｎｓ眼压计测量读数明显低于实际眼压，这可能与兔眼角膜明显较人眼薄有关，建议按本文提出的回归方程校正，以减少误差。

国产回弹式眼压计的临床评价

目的通过比较国产回弹式眼压计(rebounder tonometer,RBT)与Goldmann压平式眼压计(Goldmann applanation to-nometer,GAT)的差别来评价RBT测量的准确性,通过计算测量者间和测量者内的差异来评价其精确性,探讨其临床应用价值。方法选择2009年6月至12月在北京同仁医院眼压监测室接受昼夜眼压曲线测量的可疑青光眼患者69例138眼。其中,男40例,女29例,年龄(40.0±22.4)岁。所有患者均按RBT、GAT的顺序分别由两名检查者完成眼压测量,每种眼压计的测量均重复3次,分别记录并计算平均数作为该种眼压计的测量结果。测量者一、二需在5min内完成眼压的测量。比较两位测量者间的差值评价RBT的精确性,比较两种眼压计测量结果间的差值评价RBT的准确性。并分析眼压高低及中央角膜厚度对RBT准确性的影响。结果 RBT和GAT所测右眼的眼压值分别为(20.0±5.1)mmHg(1kPa=7.5mmHg)和(20.4±5.2)mmHg,差值为(0.4±2.5)mmHg,二者比较,差异无统计学意义(t=1.211,P=0.230)。RBT和GAT所测左眼的眼压值分别为(20.5±4.7)mmHg和(20.4±4.8)mmHg,差值为(0.1±2.0)mmHg,二者比较,差异也无统计学意义(t=-0.318,P=0.751)。两种眼压计所测眼压之间均有明显相关,左、右两眼r值分别为0.878(P=0.000)和0.912(P=0.000)。RBT不同测量者间的差异不具有显著性,测量者间相关系数在左、右眼分别为0.956和0.939,有较好的一致性。RBT测量者内相关系数在0.978～0.991,与GAT的结果接近。低眼压患者RBT的值大于GAT,高眼压患者RBT值小于GAT,正常眼压时两种仪器测得眼压的差值最小;中央角膜厚度较薄时RBT值偏低,中央角膜厚度较厚时RBT值偏高。结论 RBT的准确性和精确性可以满足临床工作的需求。