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Agreement of iCare IC200 tonometry with Perkins applanation tonometry in healthy children

Theo Stoddard-Bennett1, Nicholas J Jackson2, Laura Robbins1

  • 1Stein Eye Institute, University of California, Los Angeles.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|September 19, 2022
PubMed

Insights

The iCare IC200 rebound tonometer generally overestimates intraocular pressure (IOP) in healthy children compared to the gold standard Perkins applanation tonometer. Moderate agreement was found, and central corneal thickness did not impact IOP measurements.

Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Pediatric Medicine

Background:

  • Intraocular pressure (IOP) measurement is crucial for diagnosing and monitoring glaucoma and other eye conditions.
  • Rebound tonometry offers a non-contact method for IOP assessment, potentially improving patient comfort and accessibility.
  • Validating new tonometry devices against established methods like Goldmann applanation tonometry is essential for clinical adoption.

Purpose of the Study:

  • To evaluate the interdevice agreement between the iCare IC200 rebound tonometer and Perkins applanation tonometry in a healthy pediatric cohort.
  • To determine if the iCare IC200 shows consistent IOP measurements compared to the established gold standard in children.
  • To assess the influence of central corneal thickness (CCT) on IOP readings from both devices.

Main Methods:

  • A total of 42 eyes from 42 healthy children were included in the study.
  • IOP was measured using both the iCare IC200 and Perkins applanation tonometer.
  • Intraclass correlation coefficient (ICC) and Bland-Altman analyses were performed to assess agreement.
  • Linear regression was used to analyze the relationship between IOP and CCT for each device.

Main Results:

  • The mean IOP difference (IC200-Perkins) was 0.72 mm Hg, with an ICC of 0.63, indicating moderate agreement.
  • Bland-Altman analysis revealed 95% limits of agreement from -5.2 to +6.6 mm Hg.
  • Central corneal thickness (CCT) did not show a significant correlation with IOP measurements for either the IC200 or Perkins tonometer.

Conclusions:

  • The iCare IC200 tends to overestimate IOP in healthy children when compared to Perkins applanation tonometry.
  • There is moderate agreement between the two tonometers, but the IC200 showed a higher frequency of readings exceeding +2 mm Hg difference.
  • CCT was not found to be a significant factor influencing IOP measurements obtained by either device in this pediatric population.
Abstract

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