Comparison of Dynamic Contour Tonometry and Goldmann Applanation Tonometry in Deep Lamellar and Penetrating Keratoplasties

• Published in: American journal of ophthalmology Vol. 145; no. 2; pp. 215 - 221.e1
• Main Authors: Ceruti, Piero, Morbio, Roberta, Marraffa, Michele, Marchini, Giorgio
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-2008; Elsevier; Elsevier Limited
• Subjects: Adult; Astigmatism; Biological and medical sciences; Cornea - pathology; Corneal Diseases - surgery; Corneal Transplantation; Cross-Sectional Studies; Female; Glaucoma; Humans; Intraocular Pressure - physiology; Keratoplasty, Penetrating; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Prospective Studies; Reproducibility of Results; Studies; Surgery; Suture Techniques; Tonometry, Ocular - methods; Treatment; Contour; Dynamics; Keratoplasty; Surgery; Lamellar graft; Ophthalmology; Penetrating graft; Comparative study; Applanation tonometry
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2007.10.003

Purpose To compare the measurements of intraocular pressure (IOP) with dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) in eyes with corneal graft and to evaluate the influence of corneal thickness (CCT), corneal curvature (CC), and astigmatism on these methods. Design Prospective, observational cross-sectional study. Methods Eighteen eyes of 18 patients after penetrating keratoplasty (PKP) and 14 eyes of 14 patients after deep lamellar keratoplasty (DLKP) underwent IOP evaluation with DCT and GAT, and measurements of CCT, CC, and astigmatism. Bland-Altman plots were used to evaluate the agreement between tonometers. Multivariate regression analysis was used to evaluate the influence of ocular structural factors and running suture on IOP measurements obtained with both tonometers. Results IOP values obtained by DCT and GAT were strongly correlated in all eyes ( r = .91; P < .001). DCT values measured 2.5 ± 1.7 mm Hg higher than GAT readings ( P < .001). A reduction of the mean IOP difference between DCT and GAT with an increase in IOP values ( P < .001) was found. Regression analysis showed no effect of CCT, CC, astigmatism, and running suture on both DCT and GAT readings, either in DLKP or in PKP eyes. Conclusions We found a good overall correlation between both tonometers but the agreement between instruments differs in high or low IOP ranges. The wide and varying 95% limits of agreement between DCT and GAT indicates that DCT provides IOP measurements on deep lamellar and penetrating keratoplasties which can be used in the clinical practice.