Lee Sang Yeop, Bae Hyoung Won, Kwon Hee Jung, Seong Gong Je, Kim Chan Yun
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
PLoS One. 2018 Feb 5;13(2):e0192344. doi: 10.1371/journal.pone.0192344. eCollection 2018.
The utility of Goldmann applanation tonometry (GAT) for monitoring intraocular pressure (IOP) in open-angle glaucoma (OAG) patients with a history of laser refractive surgery was investigated by comparing IOP fluctuations measured using GAT and dynamic contour tonometry (DCT) on the same day. In this retrospective study, patients were divided into one of two subgroups according to IOP fluctuation values using GAT: 43 eyes in the low IOP fluctuation group (LIFG [GAT fluctuation ≤1.7 mmHg]); and 55 eyes in the high IOP fluctuation group (HIFG [GAT fluctuation >1.7 mmHg]). IOP fluctuation was defined as the standard deviation of all IOP values during follow-up. IOP parameters using GAT were compared with those of DCT. Correlation analyses were performed among IOP parameters, and between IOP fluctuation and associated factors including central corneal thickness, corneal curvature, and axial length. All IOP parameters demonstrated significantly high values in the HIFG compared with those in the LIFG. Mean and peak IOP using DCT were significantly higher than those using GAT in both groups. However, there were no significant differences in IOP fluctuation and reduction using both tonometry methods in the HIFG (p = 0.946 and p = 0.986, respectively). Bland-Altman analysis revealed similar fluctuations using GAT and DCT. In multivariate analyses, there was a significant correlation between fluctuations using GAT and DCT in the HIFG (p = 0.043). These results suggest that IOP monitoring using GAT is a reliable method of monitoring IOP change in glaucoma patients with a history of laser refractive surgery, especially those exhibiting high IOP fluctuation. Nevertheless, several factors, including central corneal thickness, corneal curvature, and axial length, should be considered when using GAT for IOP monitoring.
通过比较同一天使用戈德曼压平眼压计（GAT）和动态轮廓眼压计（DCT）测量的眼压波动情况，研究了GAT在监测有激光屈光手术史的开角型青光眼（OAG）患者眼压方面的效用。在这项回顾性研究中，根据使用GAT测量的眼压波动值，将患者分为两个亚组之一：低眼压波动组（LIFG [GAT波动≤1.7 mmHg]）中的43只眼；高眼压波动组（HIFG [GAT波动>1.7 mmHg]）中的55只眼。眼压波动定义为随访期间所有眼压值的标准差。将使用GAT的眼压参数与DCT的眼压参数进行比较。对眼压参数之间以及眼压波动与包括中央角膜厚度、角膜曲率和眼轴长度在内的相关因素之间进行了相关性分析。与LIFG相比，HIFG中的所有眼压参数均显示出显著更高的值。两组中使用DCT测量的平均眼压和峰值眼压均显著高于使用GAT测量的值。然而，在HIFG中，两种眼压计测量方法在眼压波动和眼压降低方面均无显著差异（分别为p = 0.946和p = 0.986）。布兰德-奥特曼分析显示，使用GAT和DCT的波动情况相似。在多变量分析中，HIFG中使用GAT和DCT测量的波动之间存在显著相关性（p = 0.043）。这些结果表明，对于有激光屈光手术史的青光眼患者，尤其是眼压波动较大的患者，使用GAT监测眼压变化是一种可靠的方法。然而，在使用GAT进行眼压监测时，应考虑包括中央角膜厚度、角膜曲率和眼轴长度在内的几个因素。
