Division of Ophthalmology, Cumming School of Medicine, Calgary, Alta.
Department of Ophthalmology, Western University, London, Ont.
Can J Ophthalmol. 2018 Jun;53(3):252-259. doi: 10.1016/j.jcjo.2017.09.013. Epub 2017 Nov 27.
The Goldmann applanation tonometer is the gold standard for measuring intraocular pressure and a possible vector for the transmission of infectious diseases. The purpose of this study is to consolidate the evidence pertaining to the disinfection of Goldmann tonometers in an effort to facilitate an informed discussion regarding public policy in this important area.
Systematic review.
An exhaustive literature review was undertaken to identify primary-level research that assesses the effectiveness of different agents used in the disinfection of Goldmann applanation tonometer prisms. Seven discrete databases were reviewed by 2 independent researchers, and a symmetrical screening process was used to identify and review all pertinent studies.
Our review identified only 19 primary-level studies that relate specifically to the disinfection of Goldmann tonometer prisms. These studies are largely heterogeneous with regard to the pathogens and disinfectants that were tested and the experimental protocols that were employed. Accordingly, definitive conclusions as to the optimal agent cannot be made on this basis. Furthermore, the results of our review reinforce previous suggestions that only adenovirus has been transmitted between patients via the Goldmann tonometer.
The present state of the literature does not permit a definitive conclusion regarding optimal disinfection agent for Goldmann applanation tonometer prisms. Further well-constructed studies are required to better delineate the effectiveness of disinfectants in the specific context of tonometer prisms.
压平式眼压计是测量眼内压的金标准，也是传染疾病传播的可能载体。本研究旨在整合有关金氏眼压计消毒的证据，以促进在这一重要领域的公共政策方面进行知情讨论。
系统评价。
我们进行了全面的文献回顾，以确定评估用于金氏压平眼压计棱镜消毒的不同试剂的有效性的初级研究。由 2 名独立研究人员审查了 7 个离散数据库，并采用对称筛选过程来识别和审查所有相关研究。
我们的综述仅确定了 19 项专门研究金氏眼压计棱镜消毒的初级研究。这些研究在测试的病原体和消毒剂以及所采用的实验方案方面存在很大的异质性。因此，不能基于此得出关于最佳试剂的明确结论。此外，我们的综述结果也证实了之前的建议，即只有腺病毒通过金氏眼压计在患者之间传播。
目前的文献状况不允许对金氏压平眼压计棱镜的最佳消毒试剂做出明确的结论。需要进一步进行精心设计的研究，以更好地确定消毒剂在眼压计棱镜特定环境下的有效性。
