Strzalkowska Alicja, Pirlich Nina, Stingl Julia V, Schuster Alexander K, Rezapour Jasmin, Wagner Felix M, Buse Justus, Hoffmann Esther M
Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg, University Mainz, 55131 Mainz, Germany.
J Clin Med. 2022 May 18;11(10):2846. doi: 10.3390/jcm11102846.
Objective: We aimed to compare intraocular pressure (IOP) measurements using iCare® PRO rebound tonometry (iCare) and Perkins applanation tonometry (Perkins) in childhood glaucoma subjects and healthy children and the influence of anaesthesia depth, age and corneal thickness. Material: Prospective clinical, case-control study of children who underwent an ophthalmologic examination under general anaesthesia according to our protocol. Children were 45.45 ± 29.76 months old (mean ± SD (standard deviation)). Of all children, 54.05% were female. IOP was taken three times (T1−T3), according to duration and the depth of anaesthesia. The order of measurement alternated, starting with iCare. Agreement between the device measurements was evaluated using Bland−Altman analysis. Results: 53 glaucoma subjects and 22 healthy controls. Glaucoma subjects: IOP measured with iCare was at T1: 27.2 (18.1−33.8), T2: 21.6 (14.8−30.6), T3: 20.4 mmHg (14.5−27.0) and Perkins 17.5 (12.0−23.0), 15.5 (10.5−20.5), 15.0 mmHg (10.5−21.0) (median ± IQR (interquartile range)). Healthy controls: IOP with iCare: T1: 13.3 (11.1−17.0), T2: 10.6 (8.1−12.4), T3: 9.6 mmHg (7.7−11.7) and Perkins 10.3 (8.0−12.0), 7.0 (5.5−10.5), 7.0 mmHg (5.5−8.5) (median ± IQR). The median IOP was statistically significantly higher with iCare than with Perkins (p < 0.001) in both groups. The mean difference (iCare and Perkins) was 6.0 ± 6.1 mmHg for T1−T3, 7.3 at T1, 6.0 at T2, 4.9 mmHg at T3. Conclusion: The IOP was the highest in glaucoma subjects and healthy children at T1 (under sedation), independently of the measurement method. iCare always leads to higher IOP compared to Perkins in glaucoma and healthy subjects, regardless of the duration of anesthesia.
我们旨在比较使用iCare® PRO回弹眼压计（iCare）和帕金斯压平眼压计（Perkins）测量儿童青光眼患者和健康儿童的眼压，以及麻醉深度、年龄和角膜厚度的影响。材料：根据我们的方案，对在全身麻醉下接受眼科检查的儿童进行前瞻性临床病例对照研究。儿童年龄为45.45±29.76个月（平均值±标准差）。所有儿童中，54.05%为女性。根据麻醉持续时间和深度，眼压测量三次（T1 - T3）。测量顺序交替进行，从iCare开始。使用布兰德 - 奥特曼分析评估设备测量之间的一致性。结果：53例青光眼患者和22例健康对照。青光眼患者：用iCare测量的眼压在T1时为27.2（18.1 - 33.8），T2时为21.6（14.8 - 30.6），T3时为20.4 mmHg（14.5 - 27.0）；用帕金斯眼压计测量的眼压在T1时为17.5（12.0 - 23.0），T2时为15.5（10.5 - 20.5），T3时为15.0 mmHg（10.5 - 21.0）（中位数±四分位间距）。健康对照：用iCare测量的眼压在T1时为13.3（11.1 - 17.0），T2时为10.6（8.1 - 12.4），T3时为9.6 mmHg（7.7 - 11.7）；用帕金斯眼压计测量的眼压在T1时为10.3（8.0 - 12.0），T2时为7.0（5.5 - 10.5），T3时为7.0 mmHg（5.5 - 8.5）（中位数±四分位间距）。在两组中，iCare测量的眼压中位数均显著高于帕金斯眼压计测量的眼压（p < 0.001）。T1 - T3期间（iCare和帕金斯眼压计测量值）的平均差值为6.0±6.1 mmHg，T1时为7.3，T2时为6.0，T3时为4.9 mmHg。结论：在T1（镇静状态下），无论测量方法如何，青光眼患者和健康儿童的眼压最高。在青光眼患者和健康受试者中，无论麻醉持续时间如何，与帕金斯眼压计相比，iCare测量的眼压总是更高。
