在准分子激光原位角膜磨镶术（LASIK）前后测量眼压时，压力性光幻视眼压测量法与戈德曼压平眼压测量法的比较

Pressure phosphene tonometry versus Goldmann applanation tonometry for measuring intraocular pressure before and after LASIK.

作者信息

Shemesh Gabi, Man Oran, Michaeli Adi, Varssano David, Lazar Moshe

机构信息

Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.

出版信息

J Refract Surg. 2007 Apr;23(4):405-9. doi: 10.3928/1081-597X-20070401-13.

DOI:10.3928/1081-597X-20070401-13

PMID:17455836

Abstract

PURPOSE

To compare pressure phosphene tonometry with Goldmann applanation tonometry for measuring intraocular pressure (IOP) before and after LASIK.

METHODS

Forty-three (18 men and 25 women) consecutive healthy patients underwent complete pre- and postoperative LASIK ophthalmologic assessments including manifest and cycloplegic refraction, keratometry, and central corneal thickness. Three repetitive sets of pressure phosphene tonometry and Goldmann applanation tonometry measurements were performed the day before and 3 months following uneventful LASIK.

RESULTS

Mean preoperative spherical equivalent refraction was -4.70 +/- 2.50 diopters (D) (range: -1.50 to -12.90 D) and mean preoperative keratometry was 43.95 +/- 1.08 D. After LASIK, spherical equivalent refraction was +0.23 +/- 0.11 D and mean keratometry was 39.46 +/- 2.28 D. Preoperative pressure phosphene tonometry (12.16 +/- 1.58 mmHg) and Goldmann applanation tonometry (12.01 +/- 1.55 mmHg) IOP measurements were similar. Postoperative IOP was 10.30 +/- 1.16 mmHg with Goldmann applanation tonometry and 12.20 +/- 1.62 mmHg with pressure phosphene tonometry. The postoperative IOP difference between Goldmann applanation tonometry and pressure phosphene tonometry was 0.15 +/- 1.12 mmHg (P = .41). The mean change in pachymetry after LASIK was 68.73 +/- 73 microm. The change in Goldmann applanation between preoperative and postoperative LASIK values was 1.71 +/- 1.43 mmHg (P < .0001), a change that was strongly correlated with changes in corneal thickness (R = 0.75, P < .0001) and keratometry (R = 0.72, P < .0001). No such correlations were found with pressure phosphene tonometry.

CONCLUSIONS

Goldmann applanation tonometry-measured IOP decrease after LASIK is strongly correlated with a decrease in central corneal thickness and changes in keratometry, whereas pressure phosphene tonometry-measured IOP is independent of corneal thickness. Pressure phosphene tonometry appears to be a more reliable method for recording tonometry in these patients.

摘要

目的

比较压平式眼压计与Goldmann压平眼压计在准分子激光原位角膜磨镶术（LASIK）前后测量眼压（IOP）的情况。

方法

43例（18例男性和25例女性）连续的健康患者接受了完整的LASIK术前和术后眼科评估，包括显验光和睫状肌麻痹验光、角膜曲率测量和中央角膜厚度测量。在平稳的LASIK手术前一天和术后3个月进行了三组重复的压平式眼压计和Goldmann压平眼压计测量。

结果

术前平均等效球镜度为-4.70±2.50屈光度（D）（范围：-1.50至-12.90 D），术前平均角膜曲率为43.95±1.08 D。LASIK术后，等效球镜度为+0.23±0.11 D，平均角膜曲率为39.46±2.28 D。术前压平式眼压计测量的眼压（12.16±1.58 mmHg）和Goldmann压平眼压计测量的眼压（12.01±1.55 mmHg）相似。Goldmann压平眼压计测量的术后眼压为10.30±1.16 mmHg，压平式眼压计测量的术后眼压为12.20±1.62 mmHg。Goldmann压平眼压计和压平式眼压计测量的术后眼压差异为0.15±1.12 mmHg（P = 0.41）。LASIK术后角膜厚度测量的平均变化为68.73±73微米。LASIK术前和术后Goldmann压平眼压计测量值的变化为1.71±1.43 mmHg（P < 0.0001），该变化与角膜厚度变化（R = 0.75，P < 0.0001）和角膜曲率变化（R = 0.72，P < 0.0001）密切相关。压平式眼压计测量未发现此类相关性。