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Goldmann applanation tonometry using sterile disposable silicone tonometer shields

M J Maldonado1, A Rodŕiguez-Galietero, J Cano-Parra

  • 1Department of Ophthalmology, La Fe University Hospital, Valencia, Spain.

Ophthalmology
|May 1, 1996
PubMed
Summary

Using a sterile silicone shield with Goldmann applanation tonometry slightly overestimates intraocular pressure but maintains high accuracy. This method shows promise for screening ocular hypertension and glaucoma.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Biomedical Engineering

Background:

  • Sterile single-use covers offer a convenient alternative to chemical disinfection for tonometers.
  • Evaluating the performance of disposable shields in Goldmann applanation tonometry is crucial for clinical adoption.

Purpose of the Study:

  • To assess the accuracy and performance of Goldmann applanation tonometry when using a sterile disposable silicone tonometer shield.
  • To determine if the shield impacts intraocular pressure (IOP) measurements.

Main Methods:

  • Intraocular pressure was measured in 120 eyes with and without the silicone shield by the same investigator.
  • Measurements were randomized and masked to control for potential confounding factors.
  • Correlation, sensitivity, and specificity were analyzed.

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Main Results:

  • Goldmann applanation tonometry with the silicone shield resulted in a mean overestimation of IOP by 1.9 mmHg (P=0.0001).
  • Covered and uncovered readings showed strong correlation (r=0.91, P=0.0001).
  • Sensitivity (96.3%) and specificity (68.8%) for detecting IOP ≥ 21 mmHg were high, though minor distortions and shield fitting issues occurred.

Conclusions:

  • While the silicone shield slightly increases measured IOP, readings correlate well with uncovered measurements.
  • The high sensitivity of shielded tonometry makes it a potentially valuable tool for screening ocular hypertension and glaucoma.
  • Careful attention to shield fitting is necessary to avoid measurement artifacts.