Feizi Sepehr, Faramarzi Amir, Kheiri Bahareh
Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur J Ophthalmol. 2018 Sep;28(5):582-589. doi: 10.1177/1120672118757429. Epub 2018 Mar 15.
To compare intraocular pressure measured using the Goldmann applanation tonometer with that measured using the ocular response analyzer after congenital cataract surgery.
This study included 113 eyes of 64 patients who underwent lensectomy and vitrectomy. In all, 36 eyes remained aphakic after surgery. Intraocular lens implantation was performed at the time of surgery in 47 eyes and secondarily in 30 eyes. Corneal hysteresis, corneal resistance factor, and cornea-compensated intraocular pressure were measured. The influences of independent factors on the difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer were investigated using linear regression analyses. Agreement between the two tonometers was investigated using the Bland and Altman and 95% limits of agreement analysis.
Central corneal thickness, corneal hysteresis, and corneal resistance factor were 591.2 ± 53.3 µm, 10.83 ± 2.27 mmHg, and 11.36 ± 2.14 mmHg, respectively. Cornea-compensated intraocular pressure (16.75 ± 4.82 mmHg) was significantly higher than intraocular pressure measured with Goldmann applanation tonometer (14.41 ± 2.27 mmHg, p < 0.001). Central corneal thickness (p = 0.02) and corneal hysteresis (p < 0.001) were identified as the main predictors of difference between cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer readings. A 95% limits of agreement for cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was between -4.86 and 9.53 mmHg in the entire group. Cornea-compensated intraocular pressure showed the best agreement with intraocular pressure measured with Goldmann applanation tonometer in the primary pseudophakic subgroup as compared to the other subgroups.
The Goldmann applanation tonometer and ocular response analyzer cannot be used interchangeably for measuring intraocular pressure after congenital cataract surgery. The difference between the cornea-compensated intraocular pressure and intraocular pressure measured with Goldmann applanation tonometer was primarily affected by central corneal thickness and corneal hysteresis. Among the subgroups, the primary pseudophakic subgroup had the thinnest cornea and the highest corneal hysteresis values and demonstrated the best agreement between the two tonometers.
比较先天性白内障手术后使用Goldmann压平眼压计测量的眼压与使用眼反应分析仪测量的眼压。
本研究纳入了64例行晶状体切除术和玻璃体切除术患者的113只眼。术后共有36只眼为无晶状体眼。47只眼在手术时植入人工晶状体，30只眼为二期植入。测量角膜滞后、角膜阻力因子和角膜补偿眼压。使用线性回归分析研究独立因素对角膜补偿眼压与Goldmann压平眼压计测量的眼压之间差异的影响。使用Bland和Altman分析以及95%一致性界限分析研究两种眼压计之间的一致性。
中央角膜厚度、角膜滞后和角膜阻力因子分别为591.2±53.3µm、10.83±2.27mmHg和11.36±2.14mmHg。角膜补偿眼压（16.75±4.82mmHg）显著高于Goldmann压平眼压计测量的眼压（14.41±2.27mmHg，p<0.001）。中央角膜厚度（p=0.02）和角膜滞后（p<0.001）被确定为角膜补偿眼压与Goldmann压平眼压计读数测量的眼压之间差异的主要预测因素。整个组中，角膜补偿眼压与Goldmann压平眼压计测量的眼压的95%一致性界限在-4.86至9.53mmHg之间。与其他亚组相比，在原发性人工晶状体眼亚组中，角膜补偿眼压与Goldmann压平眼压计测量的眼压一致性最佳。
先天性白内障手术后，Goldmann压平眼压计和眼反应分析仪不能互换使用来测量眼压。角膜补偿眼压与Goldmann压平眼压计测量的眼压之间的差异主要受中央角膜厚度和角膜滞后的影响。在各亚组中，原发性人工晶状体眼亚组的角膜最薄，角膜滞后值最高，两种眼压计之间的一致性最佳。
