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Goldmann Tonometer Prism with an Optimized Error Correcting Applanation Surface.

Sean McCafferty1, Garrett Lim2, William Duncan3

  • 1Intuor Technolgies, Tucson, AZ, USA ; University of Arizona Department of Ophthalmology, Tucson, AZ, USA ; University of Arizona College of Optical Science, Tucson, AZ, USA.

Translational Vision Science & Technology
|September 20, 2016
PubMed
Summary

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Intraocular Pressure Accuracy Post-Myopic Laser in situ Keratomileusis: Pivotal Study Results, Standard vs Correcting Applanation Tonometry Surface Goldmann Tonometry.

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Intraocular pressure correlation to progressive retinal nerve fiber layer loss in primary open angle glaucoma as measured by standard and modified goldmann applanation tonometers.

BMC ophthalmology·2025

A modified Goldmann tonometer prism (CATS) significantly reduces intraocular pressure measurement errors caused by corneal biomechanics and tear film. This innovation aims for more accurate IOP readings without altering the standard Goldmann measurement technique.

Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Optics

Background:

  • Goldmann applanation tonometry (GAT) is the standard for intraocular pressure (IOP) measurement.
  • GAT accuracy is significantly affected by corneal biomechanical properties and tear film dynamics.
  • Patient variability in corneal thickness, stiffness, and curvature introduces errors in IOP readings.

Purpose of the Study:

  • To evaluate an applanating surface modification for the Goldmann tonometer prism.
  • To develop a novel prism design that minimizes IOP errors stemming from patient-specific biomechanics.
  • To enhance the accuracy of Goldmann tonometry through a modified prism surface.

Main Methods:

  • A modified Goldmann prism, termed the correcting applanation tonometry surface (CATS) prism, was designed and optimized.
Keywords:
corneal biomechanicsglaucomaintraocular pressuretonometry

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  • Mathematical modeling using finite element analysis (FEA) was employed to refine the CATS prism design.
  • Manometric IOP measurements in cadaver eyes were used to validate the theoretical optimizations.

    • Main Results:

    • The optimized CATS prism design theoretically reduces corneal biomechanical and tear film errors by approximately 50%.
    • Validation in cadaver eyes showed substantial equivalence between CATS prism measurements and standard GAT in nominal eyes.
    • Mathematical modeling predicted a significant reduction in central corneal thickness (CCT) error.

    Conclusions:

    • The CATS modified Goldmann prism offers a theoretical improvement in IOP measurement accuracy.
    • This innovation can potentially reduce CCT-related errors to less than ±2 mm Hg in 100% of a standard population.
    • The CATS prism presents an easily adoptable approach to enhance Goldmann tonometer accuracy without changing measurement technique.