Arribas-Pardo Paula, Mendez-Hernandez Carmen, Cuiña-Sardiña Ricardo, Benitez-Del-Castillo José Manuel, Garcia-Feijoo Julian
1Ophthalmology Department, Hospital Clinico San Carlos, Institute of Health Care Research of the Hospital Clinico San Carlos (IdISSC), University Complutense of Madrid, Madrid, Spain 2Cooperative Research Network in Ophthalmology (RETICS), Instituto de Salud Carlos III, Madrid, Spain *
Optom Vis Sci. 2017 Oct;94(10):986-992. doi: 10.1097/OPX.0000000000001120.
Reliable intraocular pressure (IOP) measurement after intrastromal corneal ring segments (ICRS) implantation is a challenge because of altered corneal morphology. In this study, IOP is measured with four tonometers, compared with Goldmann applanation tonometry (GAT) values and the influence of corneal parameters is established.
This study compares IOP measurements made using different tonometers in patients implanted with ICRS and assesses the effects of central corneal thickness (CCT), corneal curvature, and corneal astigmatism on the IOP measurements obtained.
In this cross-sectional study, IOP was measured using three different tonometers in 91 eyes of 91 patients with corneal ectasia implanted at least 6 months previously with ICRS. The tonometers tested were the TonoPen XL, Pascal dynamic contour tonometer (DCT), and iCare Pro rebound tonometer. GAT measurements were used as reference. Agreement among the IOPs provided by the different tonometers and the influence of corneal variables on the IOP measurements obtained were assessed using the Bland-Altman method, intraclass correlation coefficients, and multiple linear regression analysis.
Mean IOP differences were GAT versus TonoPen XL -0.8 ± 3.07 mm Hg, GAT versus DCT -1.0 ± 3.26 mm Hg, and GAT versus iCare Pro 0.8 ± 2.92 mm Hg. Our multiple linear regression analysis identified CCT as a confounding factor affecting all the tonometer readings but DCT-IOP.
In patients fitted with ICRS, IOP measurements made using the iCare Pro and TonoPen XL showed most agreement with GAT. Intraocular pressure measurements made by DCT were unaffected by corneal topographic factors though this procedure slightly overestimated GAT readings.
由于角膜形态改变，基质内角膜环片（ICRS）植入术后进行可靠的眼压（IOP）测量具有挑战性。在本研究中，使用四种眼压计测量眼压，与Goldmann压平眼压计（GAT）测量值进行比较，并确定角膜参数的影响。
本研究比较了植入ICRS的患者使用不同眼压计测量的眼压，并评估中央角膜厚度（CCT）、角膜曲率和角膜散光对所测眼压的影响。
在这项横断面研究中，对91例至少在6个月前植入ICRS的圆锥角膜患者的91只眼，使用三种不同的眼压计测量眼压。所测试的眼压计为TonoPen XL、Pascal动态轮廓眼压计（DCT）和iCare Pro回弹眼压计。以GAT测量值作为参考。使用Bland-Altman方法、组内相关系数和多元线性回归分析评估不同眼压计所测眼压之间的一致性以及角膜变量对所测眼压的影响。
平均眼压差异为GAT与TonoPen XL相比为-0.8±3.07 mmHg，GAT与DCT相比为-1.0±3.26 mmHg，GAT与iCare Pro相比为0.8±2.92 mmHg。我们的多元线性回归分析确定CCT是影响除DCT眼压测量值外所有眼压计读数的混杂因素。
在植入ICRS的患者中，使用iCare Pro和TonoPen XL测量的眼压与GAT最为一致。DCT测量的眼压不受角膜地形因素影响，尽管该方法略微高估了GAT读数。
