Comparison of the corrected intraocular pressure by tonopachy with that of Goldmann applanation tonometry in normal and glaucomatous patients

Indian J Ophthalmol. 2020 Apr;68(4):620-626. doi: 10.4103/ijo.IJO_570_19.

Abstract

Purpose: To compare corrected intraocular pressure (IOP) by tonopachy with that of Goldmann applanation tonometry (GAT) in normal and glaucomatous patients.

Methods: In this cross-sectional study, IOP and central corneal thickness (CCT) were measured in 426 eyes (213 normal eyes and 213 glaucomatous eyes) of 426 patients by tonopachy followed by GAT and ultrasound pachymetry. IOP was corrected for CCT by in-built formula in tonopachy and Ehlers correction factor for Goldmann tonometer. Limits of agreements were assessed using Bland-Altman plots. Intraclass correlation coefficient was calculated to estimate the absolute agreement between single and average measurements of IOP and CCT of tonopachy with that of Goldmann tonometer and ultrasound pachymetry respectively.

Results: Mean corrected IOP measured with tonopachy and GAT in glaucomatous eyes was 17.63 ± 5.04 mmHg and 19.42 ± 5.83 mmHg, and in controls it was 13.4 ± 2.5 mmHg and 16.2 ± 3.1 mmHg, respectively. Limits of agreement ranged from -4.63 to +9.25 mmHg for total population (mean = 2.31), -6.01 to +9.59 mmHg (mean = 1.79) for glaucoma group and -2.99 to +8.65 mmHg (mean = 2.83) for controls. Intraclass correlation coefficient for IOP measurement between tonopachy and Goldmann tonometer was 0.84 for total population, 0.85 for glaucoma group, and 0.63 for controls, respectively.

Conclusion: Corrected IOP obtained by tonopachy showed moderate agreement with GAT and it is more in glaucoma patients than controls. Thus, tonopachy can be used as a screening tool, but cannot replace GAT.

Keywords: Agreement; Goldmann applanation tonometer; central corneal thickness; intraocular pressure; tonopachy.

MeSH terms

  • Cornea / diagnostic imaging
  • Cross-Sectional Studies
  • Glaucoma* / diagnosis
  • Humans
  • Intraocular Pressure*
  • Manometry
  • Reproducibility of Results
  • Tonometry, Ocular