Princess Alexandra Eye Pavilion, Department of Ophthalmology, University of Edinburgh, Edinburgh, UK.
Department of Ophthalmology, Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
J Glaucoma. 2018 Jun;27(6):511-518. doi: 10.1097/IJG.0000000000000948.
The purpose of this study was to examine the effect of corneal biomechanical properties on intraocular pressure (IOP) measurements obtained using a rebound self-tonometer (Icare HOME) compared with Goldmann applanation tonometry (GAT).
An observational study of 100 patients with glaucoma or ocular hypertension. All had a comprehensive ophthalmic examination and standard automated perimetry. IOP was assessed by GAT, Icare HOME and Ocular Response Analyzer, which was also used to assess corneal hysteresis (CH) and corneal resistance factor (CRF). Central corneal thickness (CCT) was recorded.
Mean (±SD) IOP measurements were 14.3±3.9 and 11.7±4.7 mm Hg using GAT and Icare HOME, respectively. Average CCT, CRF, and CH were 534.5±37.3 μm, 9.0±1.7 mm Hg, and 9.4±1.5 mm Hg, respectively. The mean difference between Icare HOME and GAT was -2.66±3.13 mm Hg, with 95% limits of agreement of -8.80 to 3.48 mm Hg, however, there was evidence of proportional bias. There was negative correlation between IOP and CH [5.17 mm Hg higher Icare HOME IOP (P=0.041, R=0.029) and 7.23 mm Hg higher GAT IOP (P=0.008, R=0.080) for each 10 mm Hg lower CH], whereas thinner CCT was significantly associated with lower IOP (P<0.001, R=0.14 for Icare HOME and P<0.001, R=0.08 for GAT). In multivariable analysis, although CRF and CH remained associated with IOP measured using either GAT or Icare HOME, CCT was no longer significant.
IOP measurements obtained using a self-tonometer, similar to GAT, were more influenced by overall corneal biomechanics than CCT.
本研究旨在探讨角膜生物力学特性对回弹眼压计（Icare HOME）与压平眼压计（GAT）测量眼压（IOP）的影响。
对 100 例青光眼或高眼压患者进行观察性研究。所有患者均进行全面眼科检查和标准自动视野检查。使用 GAT、Icare HOME 和眼反应分析仪评估 IOP，同时评估角膜滞后（CH）和角膜阻力因子（CRF）。记录中央角膜厚度（CCT）。
GAT 和 Icare HOME 测量的平均（±SD）IOP 分别为 14.3±3.9 和 11.7±4.7mmHg。平均 CCT、CRF 和 CH 分别为 534.5±37.3μm、9.0±1.7mmHg 和 9.4±1.5mmHg。Icare HOME 与 GAT 的平均差值为-2.66±3.13mmHg，95%一致性界限为-8.80 至 3.48mmHg，但存在比例偏差的证据。IOP 与 CH 呈负相关[Icare HOME IOP 高 5.17mmHg（P=0.041，R=0.029）和 GAT IOP 高 7.23mmHg（P=0.008，R=0.080），每降低 10mmHg 的 CH]，而 CCT 越薄，IOP 越低（P<0.001，R=0.14 用于 Icare HOME 和 P<0.001，R=0.08 用于 GAT）。在多变量分析中，尽管 CRF 和 CH 仍与 GAT 或 Icare HOME 测量的 IOP 相关，但 CCT 不再显著。
与 GAT 相似，使用回弹眼压计测量的 IOP 受整体角膜生物力学特性的影响大于 CCT。
