Rödter Tara Helena, Knippschild Stephanie, Baulig Christine, Krummenauer Frank
Institute for Medical Biometry and Epidemiology, Faculty of Health, Witten/Herdecke University, Witten, Germany.
Eur J Ophthalmol. 2020 Mar;30(2):245-252. doi: 10.1177/1120672119866067. Epub 2019 Aug 29.
The Icare PRO rebound tonometer is being promoted as a patient-friendly device for glaucoma detection and monitoring, allowing rapid and accurate intraocular pressure measurement avoiding anaesthesia. The aim of this systematic review was to examine the concordance of Icare PRO and Goldmann applanation tonometry in glaucoma patients.
The German and English literature research was carried out using PubMed and Cochrane Library between January 2010 and March 2018. Method comparison trials in a paired sample study design were identified. Search criteria were 'Icare PRO', 'Rebound', 'Goldmann' and 'Applanation'. Adult patients with glaucoma of any aetiology were included. The intraindividual intraocular pressure deviation between Icare PRO and Goldmann applanation tonometry (mm Hg) served as primary endpoint, parameterized by the reported mean differences. For each study, an asymptotic 95% confidence interval was derived. The overall intraocular pressure meta-difference (Icare PRO-Goldmann applanation tonometry) and 95% confidence interval were estimated using the random effect model.
Of 147 publications, 6 studies (672 eyes) were included after reviewing. Four studies showed an intraocular pressure underestimation by the Icare PRO, two an overestimation. The meta-difference (Icare PRO-Goldmann applanation tonometry = -0.14 mm Hg; 95% confidence interval: (-0.43 mm Hg; 0.15 mm Hg)) indicated a non-significant, clinically irrelevant mean deviation (p = 0.335). The devices showed good agreement, but there was a strong heterogeneity between the studies (I² = 77%): two studies presented a significant difference (Icare PRO-Goldmann applanation tonometry), however, with deviations in opposite directions.
Although the manufacturer advertises the Icare PRO as a 'tonometer with superior accuracy', the present review could neither confirm nor deny considerable agreement between Goldmann applanation tonometry and Icare PRO in glaucomatous patients.
Icare PRO回弹眼压计作为一种便于患者使用的设备被推广用于青光眼检测和监测，它能够在无需麻醉的情况下快速准确地测量眼压。本系统评价的目的是检验Icare PRO与Goldmann压平眼压计在青光眼患者中的一致性。
于2010年1月至2018年3月期间使用PubMed和Cochrane图书馆进行德语和英语文献检索。确定配对样本研究设计中的方法比较试验。检索标准为“Icare PRO”“回弹”“Goldmann”和“压平”。纳入任何病因的成年青光眼患者。Icare PRO与Goldmann压平眼压计之间的个体眼压偏差（mmHg）作为主要终点，以报告的平均差异进行参数化。对于每项研究，得出渐近95%置信区间。使用随机效应模型估计总体眼压元差异（Icare PRO - Goldmann压平眼压计）和95%置信区间。
在147篇出版物中，经审查后纳入6项研究（672只眼）。4项研究显示Icare PRO低估眼压，2项研究显示高估眼压。元差异（Icare PRO - Goldmann压平眼压计 = -0.14 mmHg；95%置信区间：（-0.43 mmHg；0.15 mmHg））表明平均偏差无统计学意义，临床相关性不大（p = 0.335）。两种设备显示出良好的一致性，但研究之间存在很强的异质性（I² = 77%）：两项研究呈现出显著差异（Icare PRO - Goldmann压平眼压计），然而，偏差方向相反。
尽管制造商将Icare PRO宣传为“具有卓越准确性的眼压计”，但本评价既不能证实也不能否认Goldmann压平眼压计与Icare PRO在青光眼患者中存在相当程度的一致性。
