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A comparison of Icare PRO and Perkins tonometers in anesthetized children

Massimiliano Serafino1, Edoardo Villani1, Andrea Lembo2

  • 1Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, University of Milan, Via San Vittore, 12, 20123, Milan, Italy.

International Ophthalmology
|July 18, 2019
PubMed

Insights

The Perkins applanation tonometer (PAT) shows higher reliability for measuring intraocular pressure (IOP) in children compared to the Icare PRO (ICP). Both devices demonstrated a significant correlation between IOP and central corneal thickness (CCT).

Area of Science:

  • Ophthalmology
  • Pediatric Eye Care
  • Ophthalmic Instrumentation

Background:

  • Accurate intraocular pressure (IOP) measurement is critical in pediatric ophthalmology, particularly in aphakic or strabismus patients.
  • Existing tonometers may have limitations in accuracy and reliability in pediatric populations.
  • Central corneal thickness (CCT) is a known factor influencing IOP readings.

Purpose of the Study:

  • To compare IOP measurements between the Perkins applanation tonometer (PAT) and Icare PRO (ICP) in anesthetized children.
  • To evaluate intra-operator and inter-operator reliability for both tonometer devices.
  • To assess the influence of central corneal thickness (CCT) on IOP measurements obtained by PAT and ICP.

Main Methods:

  • Seventy children undergoing examination under anesthesia were included.
  • IOP was measured twice with PAT and ICP by two operators on each eye.
  • Central corneal thickness (CCT) was measured using ultrasound pachymetry; Bland-Altman analyses and intraclass correlation coefficients (ICC) were used for evaluation.

Main Results:

  • The Icare PRO (ICP) tended to overestimate IOP compared to the Perkins applanation tonometer (PAT), with a mean difference of 1.97 mmHg.
  • Repeatability and reproducibility were higher for PAT (repeatability 0.96, reproducibility 0.76) than for ICP (repeatability 0.81, reproducibility 0.70).
  • A significant correlation (r=0.66) was found between IOP and CCT for both instruments.

Conclusions:

  • The Perkins applanation tonometer (PAT) demonstrates superior repeatability and reproducibility for IOP measurements in pediatric patients compared to the Icare PRO (ICP).
  • ICP tends to overestimate IOP relative to PAT in this cohort.
  • Both tonometers showed a significant correlation with central corneal thickness (CCT), highlighting its importance in IOP assessment.
Abstract

Keywords:
IcareIntraocular pressurePediatric glaucomaPerkinsTonometer

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