Intraocular pressure measured with Goldmann, noncontact, Schiøtz, and dynamic contour tonometry after DSEK

To compare intraocular pressure (IOP) measurements with various tonometers after Descemet stripping with endothelial keratoplasty (DSEK) and to measure the change in IOP during the follow-up period.

A total of 28 eyes of 28 patients having undergone DSEK for bullous keratopathy by a single surgeon from June 2008 to November 2011 were enrolled in this study. IOP values, which were measured with Goldmann applanation tonometry (GAT), noncontact tonometry (NCT), Schiøtz indentation tonometry (SIT), and dynamic contour tonometry, and central corneal thickness values were reviewed and analyzed up to 3 years after DSEK (range, 1 months-3 years).

Different tonometers measured the IOP after DSEK differently. NCT showed the lowest IOP values, although GAT and NCT showed the smallest intertonometry difference. SIT showed extreme variation in IOP measurements. The dynamic contour tonometry values were higher than those of NCT or GAT. Central corneal thickness did not correlate with any of the IOP measurements. Only 2 episodes of IOP elevation greater than 30 mm Hg were detected.

IOP measured with NCT or GAT may be lower than the real IOP after DSEK. SIT is not a reliable tonometry measurement after DSEK. Additional IOP measurements using different methods and consideration of other clinical signs may be the best method for ocular evaluation after DSEK.