Department of Ophthalmology, University of Cologne, Cologne, Germany.
Graefes Arch Clin Exp Ophthalmol. 2011 Nov;249(11):1713-9. doi: 10.1007/s00417-011-1785-7. Epub 2011 Aug 14.
To compare intraocular pressure (IOP) measurements obtained by the Icare ONE rebound tonometer (RTONE) and the Goldmann applanation tonometer (GAT) in healthy persons and glaucoma patients in a prospective study, and to investigate the influence of central corneal thickness (CCT).
Measurements on 126 right eyes were obtained by three equally skilled ophthalmologists with each of the above-mentioned tonometers. In addition, patients measured their own IOP with the RTONE (RTONE(p)). The means and standard deviation for all tonometers were compared. Agreement between the tonometers was calculated using the Bland-Altman method.
A total of 95 (75.3%) patients were able to perform correct self-tonometry. Mean IOPs obtained were 17.1 ± 5.9 mmHg (RTONE performed by ophthalmologist: RTONE (o)), 17.3 ± 5.6 mmHg (RTONE(p)) and 16.5 ± 5.1 mmHg (GAT). Correlation analysis indicated a good correlation between IOP readings obtained using RTONE(o) and RTONE(p) (ρ = 0.916; p < 0.001) and RTONE(o) and GAT (ρ = 0.901; p < 0.001). Bland-Altman analysis revealed a mean difference (bias) between RTONE(o) and RTONE(p), between RTONE(o) and GAT, and between RTONE(p) and GAT of -0.2, 0.6, and 0.8 mmHg, respectively, with 95% limits of agreement of -5.0 to 4.5, -4.4 to 5.6, and -4.6 to 6.1 mmHg, respectively. The difference between RTONE(o) and GAT significantly increased with increasing CCT (ρ = 0.004), with a 10% increase in CCT resulting in a 1.8% increase in the difference.
Measurements obtained with the RTONE, either by an ophthalmologist or by the patient, showed an excellent correlation with those provided by applanation tonometry. RTONE generally tends to overestimate IOP compared to GAT readings and displays a dependence on CCT. This study was registered with the DRKS (German Clinical Trials Register; www.germanctr.de ; DRKS00000478).
本前瞻性研究旨在比较健康人群和青光眼患者应用 Icare ONE 回弹眼压计（RTONE）和 Goldmann 压平眼压计（GAT）测量的眼压（IOP），并探讨中央角膜厚度（CCT）的影响。
由 3 名同等熟练的眼科医生分别使用上述两种眼压计对 126 只右眼进行测量。此外，患者使用 RTONE 自行测量眼压（RTONE(p)）。比较所有眼压计的平均值和标准差。使用 Bland-Altman 方法计算眼压计之间的一致性。
共有 95 例（75.3%）患者能够正确进行自我眼压测量。眼科医生操作 RTONE 测量的平均眼压为 17.1 ± 5.9mmHg（RTONE(o)），患者使用 RTONE(p)测量的平均眼压为 17.3 ± 5.6mmHg，GAT 测量的平均眼压为 16.5 ± 5.1mmHg。相关性分析表明，RTONE(o)和 RTONE(p)（ρ=0.916；p<0.001）以及 RTONE(o)和 GAT（ρ=0.901；p<0.001）的 IOP 读数之间存在良好的相关性。Bland-Altman 分析显示，RTONE(o)和 RTONE(p)之间、RTONE(o)和 GAT 之间以及 RTONE(p)和 GAT 之间的平均差异（偏差）分别为-0.2mmHg、0.6mmHg 和 0.8mmHg，95%一致性区间分别为-5.0mmHg 至 4.5mmHg、-4.4mmHg 至 5.6mmHg 和-4.6mmHg 至 6.1mmHg。RTONE(o)和 GAT 之间的差异随着 CCT 的增加而显著增加（ρ=0.004），CCT 增加 10%会导致差异增加 1.8%。
由眼科医生或患者使用 RTONE 测量的 IOP 与压平眼压计测量的结果具有极好的相关性。与 GAT 读数相比，RTONE 通常会高估 IOP，并显示出对 CCT 的依赖性。本研究在 DRKS（德国临床试验注册中心；www.germanctr.de；DRKS00000478）注册。
