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Which tonometry in eyes with keratoconus?

H Altinkaynak1, C Kocasarac2, H Dundar3

  • 1Department of Ophthalmology, Ankara Ataturk Education and Research Hospital, Yıldirim Beyazit University, Ankara, Turkey.

Eye (London, England)
|December 5, 2015
PubMed
Summary

Dynamic contour tonometry (DCT) and corneal-compensated IOP (IOPcc) show stable intraocular pressure (IOP) measurements in keratoconus eyes across Amsler grades. However, no single IOP technique is interchangeable for monitoring keratoconus progression.

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Area of Science:

  • Ophthalmology
  • Corneal Diseases
  • Tonometry

Background:

  • Keratoconus is a progressive corneal ectasia affecting intraocular pressure (IOP) measurement accuracy.
  • Accurate IOP monitoring is crucial for managing glaucoma risk in keratoconus patients.
  • Existing tonometry methods may be influenced by corneal changes in keratoconus.

Purpose of the Study:

  • To compare IOP measurements from Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), Tonopen (TP), and ocular response analyzer (ORA) in keratoconus.
  • To assess the impact of Amsler grade and central corneal thickness (CCT) on IOP readings in keratoconus.
  • To identify IOP measurement techniques most reliable for keratoconus follow-up.

Main Methods:

  • 202 eyes with keratoconus were classified into four Amsler-Krumeich grades.
  • IOP was measured using GAT, DCT, TP, and ORA.
  • Statistical analysis compared IOP readings across Amsler grades and correlated them with CCT.

Main Results:

  • DCT and IOPcc showed no significant difference across Amsler grades, unlike GAT, TP, and ORA in later stages (Amsler II-IV).
  • No significant association was found between DCT IOP or IOPcc and CCT.
  • Significant differences in IOP measurements were observed among the four tonometers in Amsler II, III, and IV stages.

Conclusions:

  • DCT and IOPcc appear to be the most stable IOP measurement techniques in eyes with varying stages of keratoconus.
  • These techniques demonstrated no significant difference between keratoconus stages and a control group.
  • No single IOP measurement technique is interchangeable for monitoring keratoconus patients, necessitating careful selection for longitudinal follow-up.