Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
Br J Ophthalmol. 2018 Nov;102(11):1515-1519. doi: 10.1136/bjophthalmol-2017-311587. Epub 2018 Feb 2.
BACKGROUND/AIMS: To investigate the effect of eyelid manipulation on the measurement of intraocular pressure (IOP) using two different tonometries (rebound tonometry (RT) vs Goldmann applanation tonometry (GAT)).
103 patients with primary open-angle glaucoma were prospectively enrolled. For all of the patients, IOP measurements were performed in three different ways: (1) RT with lid manipulation (LM), (2) RT without LM and (3) GAT. The order of the three measurements was randomly selected. Additionally, the palpebral fissure height (PFH; elliptical space between upper and lower eyelids) was measured.
The mean value of IOP measured by GAT was 13.97±2.80 mm Hg, which was not significantly different from that by RT without LM (13.75±2.44 mm Hg; P=0.096), but which was significantly lower than that by RT with LM (15.21±2.91 mm Hg; P<0.001). On a Bland-Altman plot, RT with LM was overestimated relative to GAT (mean: -1.5) and RT without LM (mean: -1.2). Among the high IOPs (>20 mm Hg), interestingly, those measured by RT without LM were significantly lower than those measured by GAT (P<0.001). In the subgroup analysis of PFH, the smaller the PFH, the more exaggerated the IOP difference between GAT (P=0.014) and RT with LM (P<0.001).
RT-measured IOP was significantly exaggerated when manipulation was applied to the eyelid. This overall trend was more pronounced when PFH was small. GAT-measured IOP, meanwhile, showed a good correlation with IOP measured using RT without LM.
背景/目的：研究两种眼压计（回弹眼压计（RT）与压平眼压计（GAT））在眼睑操作时对眼压（IOP）测量的影响。
前瞻性纳入 103 例原发性开角型青光眼患者。所有患者均以三种不同方式进行 IOP 测量：（1）有眼睑操作的 RT（LM），（2）无 LM 的 RT，（3）GAT。三种测量的顺序随机选择。此外，还测量了睑裂高度（PFH；上下眼睑之间的椭圆形空间）。
GAT 测量的平均 IOP 值为 13.97±2.80 mm Hg，与无 LM 的 RT（13.75±2.44 mm Hg；P=0.096）相比无显著差异，但明显低于 LM 的 RT（15.21±2.91 mm Hg；P<0.001）。在 Bland-Altman 图上，LM 的 RT 相对于 GAT（平均差值：-1.5）和无 LM 的 RT（平均差值：-1.2）被高估。有趣的是，在高 IOPs（>20 mm Hg）中，无 LM 的 RT 测量值明显低于 GAT（P<0.001）。在 PFH 的亚组分析中，PFH 越小，GAT（P=0.014）和 LM 的 RT（P<0.001）之间的 IOP 差异越大。
当眼睑操作时，RT 测量的 IOP 显著夸大。当 PFH 较小时，这种总体趋势更为明显。同时，GAT 测量的 IOP 与无 LM 的 RT 测量的 IOP 具有良好的相关性。
