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[Rebound tonometry and applanation tonometry during narcosis investigation of pediatric glaucoma]
A Rosentreter1, A M Schild, A Lappas
1Zentrum für Augenheilkunde, Universität zu Köln, Joseph-Stelzmann-Straße 9, 50931, Köln, Deutschland. andre.rosentreter@googlemail.com
Insights
The iCare rebound tonometer offers comparable intraocular pressure (IOP) measurements to the Perkins tonometer for childhood glaucoma patients under general anesthesia, with a slight tendency towards higher readings.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Glaucoma Research
Context:
- Infantile glaucoma management requires accurate intraocular pressure (IOP) monitoring.
- General anesthesia presents challenges for IOP measurement in pediatric patients.
- Comparing non-invasive tonometry methods is crucial for clinical utility.
Purpose:
- To compare the accuracy and reliability of the iCare rebound tonometer (RBT) against the Perkins handheld applanation tonometer (Perkins) for measuring IOP in pediatric glaucoma patients under general anesthesia.
- To assess the agreement and potential biases between the two tonometry devices in this specific clinical setting.
Summary:
- A prospective trial included 45 eyes of pediatric patients with childhood glaucoma.
- Bland-Altman analysis revealed a systemic bias of 1.96 mmHg and a 95% confidence interval of -3.35 to 7.26.
- Linear regression indicated a proportional error (gradient=0.16, r(2)=0.23, p<0.01), with RBT showing agreement within 2 mmHg in nearly two-thirds of cases.
Impact:
- The iCare rebound tonometer demonstrates clinical utility for IOP assessment in pediatric glaucoma cases during general anesthesia.
- Findings suggest RBT provides comparable IOP values to applanation tonometry, aiding clinical decision-making.
- This comparison supports the use of RBT as a viable alternative in specific anesthetic scenarios for childhood glaucoma management.
Background:
A comparison of intraocular pressure (IOP) in cases of infantile glaucoma during general anesthesia was carried out by measurement with the iCare rebound tonometer (RBT) and a handheld applanation tonometer (Perkins).
Methods:
A total of 45 eyes from pediatric patients with childhood glaucoma were included in this prospective trial. Bland-Altman plots and linear regression were used for statistical analysis.
Results:
In almost two thirds of the eyes the difference between RBT and Perkins was 2 mmHg or less. A systemic bias of 1.96 mmHg and a 95% confidence interval of -3.35 to 7.26 was detected. Linear regression of the Bland-Altman data showed a proportional error (gradient=0.16; r(2)=0.23; p<0.01).
Conclusions:
The iCare rebound tonometer is useful during general anesthesia in cases of childhood glaucoma. It provides comparable IOP values to applanation tonometry with a tendency to record higher values.
