Maldonado M J, Rodŕiguez-Galietero A, Cano-Parra J, Menezo J L, Díaz-LLopis M
Department of Ophthalmology, La Fe University Hospital, Valencia, Spain.
Ophthalmology. 1996 May;103(5):815-21. doi: 10.1016/s0161-6420(96)30610-6.
Placement of a sterile single-use cover over the tonometer tip may be a convenient and safe alternative method to repeated chemical disinfection. This study was undertaken to evaluate the accuracy and performance of Goldmann applanation tonometry using a sterile disposable silicone tonometer shield over the biprism tip.
The same investigator measured intraocular pressure in 120 eyes with and without the shield. The eyes were tested randomly first with either the uncovered or the covered tonometer to control for the possible effects of repeated tonometry influencing measurement differences. Readings were recorded independently in a masked fashion.
The intraocular pressure measurements evaluated with the silicone shield caused an average overestimation of the true intraocular pressure of 1.9 +/- 1.9 mmHg (P = 0.0001). Covered and uncovered readings correlated well (r = 0.91, P = 0.0001). The sensitivity and specificity of the covered tonometry in detection intraocular pressures of 21 mmHg or higher (as measured without the shield) were 96.3% and 68.8%, respectively. Minor distortions of the normal-appearing fluorescein bands were seen in 5% of the tonometries, and the shield had to be replaced because of bubbles or wrinkles on the applanating surface in 3.3% of the measurements, which means that care must be taken when fitting the shield.
Although covered and uncovered tonometry readings correlated well, an overall trend for a slightly increased measured intraocular pressure as a result of using the silicone shield over the Goldmann tonometer tip was found. The outstanding sensitivity of this procedure in detecting increased intraocular pressure suggests that it can be useful in screening for ocular hypertension and glaucoma.
在眼压计尖端放置一次性无菌罩可能是一种方便且安全的替代重复化学消毒的方法。本研究旨在评估使用双棱镜尖端上的无菌一次性硅胶眼压计防护罩的Goldmann压平眼压测量法的准确性和性能。
同一名研究者对120只眼睛在有防护罩和无防护罩的情况下测量眼压。首先随机对眼睛进行未覆盖或覆盖眼压计的测试，以控制重复眼压测量可能影响测量差异的效应。读数以盲法独立记录。
使用硅胶防护罩评估的眼压测量值导致对真实眼压的平均高估为1.9±1.9 mmHg（P = 0.0001）。覆盖和未覆盖情况下的读数相关性良好（r = 0.91，P = 0.0001）。覆盖眼压测量法检测眼压为21 mmHg或更高（如未使用防护罩时所测）的敏感性和特异性分别为96.3%和68.8%。在5%的眼压测量中观察到正常外观的荧光素带出现轻微变形，在3.3%的测量中，由于压平表面出现气泡或褶皱，防护罩必须更换，这意味着安装防护罩时必须小心。
尽管覆盖和未覆盖眼压测量读数相关性良好，但发现使用Goldmann眼压计尖端上的硅胶防护罩会导致测量的眼压略有升高的总体趋势。该方法在检测眼压升高方面的出色敏感性表明它可用于筛查高眼压症和青光眼。
