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Published on: August 3, 2018
Goldmann tonometry tear film error and partial correction with a shaped applanation surface.
Sean J McCafferty1,2,3,4, Eniko T Enikov5, Jim Schwiegerling2,3
1Intuor Technologies.
The correcting applanation tonometry surface (CATS) prism significantly reduces tear film adhesion error compared to the Goldmann applanation tonometer (GAT) prism. This innovation offers more accurate intraocular pressure measurements by minimizing fluid bridge interference.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Optics
Background:
- Intraocular pressure measurement is crucial for glaucoma diagnosis and management.
- Goldmann applanation tonometry (GAT) is a standard method, but susceptible to errors.
- Tear film adhesion can introduce inaccuracies in applanation tonometry readings.
Purpose of the Study:
- To quantify the tear film adhesion error in Goldmann applanation tonometer (GAT) prisms.
- To quantify the tear film adhesion error in correcting applanation tonometry surface (CATS) prisms.
- To compare the tear film adhesion error between GAT and CATS prisms.
Main Methods:
- Separation force measurement of tonometer prisms adhered by tear film to simulated corneas.
- Utilized acrylic hemispheres to simulate corneal applanation contact for GAT and CATS prisms.
- Employed artificial tears and fluorescein solutions as fluid bridges, measuring applanation mire thickness and validating with human cadaver eyes.
Main Results:
- CATS prism exhibited significantly less tear film adhesion error (2.74±0.21 mmHg) than GAT prism (4.57±0.18 mmHg).
- Tear film adhesion error was largely independent of applanation mire thickness.
- Fluorescein solution increased tear film error compared to artificial tears; cadaver eye validation confirmed CATS prism's lower error (1.40±0.51 mmHg vs. GAT's 3.30±0.38 mmHg).
Conclusions:
- Goldmann applanation tonometer (GAT) tear film adhesion error is higher than previously estimated.
- The correcting applanation tonometry surface (CATS) prism demonstrated a significant 41% reduction in tear film adhesion error.
- Fluorescein solution enhances tear film adhesion, while mire thickness has minimal impact.
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