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Pascal, ICare and Goldmann applanation tonometry--a comparative study.

Gauti Jóhannesson1, Per Hallberg, Anders Eklund

  • 1Department of Clinical Sciences, Ophthalmology, Umeå University, Sweden. gauti.johannesson@ophthal.umu.se

Acta Ophthalmologica
|December 21, 2007
PubMed
Summary

This study compared intraocular pressure (IOP) measurements from Pascal, ICare, and Goldmann applanation tonometry (GAT). While all methods showed variability, ICare depended on central corneal thickness (CCT), and GAT/Pascal on corneal curvature.

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Optometry

Background:

  • Intraocular pressure (IOP) is a key metric in glaucoma diagnosis and management.
  • Accurate IOP measurement is crucial, but influenced by corneal biomechanical properties.
  • Goldmann applanation tonometry (GAT) is the clinical standard, but newer devices aim for improved accuracy and ease of use.

Purpose of the Study:

  • To compare IOP measurements using Pascal, ICare, and GAT.
  • To evaluate the influence of central corneal thickness (CCT) and corneal curvature on IOP readings.
  • To assess the intra-observer variability of these tonometry methods.

Main Methods:

  • Prospective, single-center study involving 150 eyes with a wide pressure range.
  • Six masked IOP measurements were taken per eye for each of the three devices.

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  • Central corneal thickness and curvature were measured for each eye, with GAT serving as the reference method.

    • Main Results:

    • Pascal and ICare IOP measurements showed good correlation with GAT (r=0.91, 0.89).
    • ICare readings averaged 2 mmHg higher than GAT; Pascal showed higher readings at low IOP and lower at high IOP.
    • CCT significantly correlated with IOPGAT and IOPICare, but not IOPPascal. Corneal curvature correlated with IOPGAT and IOPPascal, but not IOPICare. Intra-observer variability was approximately 2 mmHg for all methods.

    Conclusions:

    • The three IOP measurement devices demonstrated reasonable correlation and concordance.
    • No method was entirely independent of corneal biomechanical properties.
    • ICare IOP measurements were significantly influenced by CCT, while GAT and Pascal were influenced by corneal curvature. All methods exhibited intra-observer variability.