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  • Title: Comparison of intraocular pressure measurement using 4 different instruments following penetrating keratoplasty.
    Author: Chou CY, Jordan CA, McGhee CN, Patel DV.
    Journal: Am J Ophthalmol; 2012 Mar; 153(3):412-8. PubMed ID: 22000702.
    Abstract:
    PURPOSE: To compare intraocular pressure (IOP) measurements after penetrating keratoplasty (PK) using Goldmann applanation tonometry (GAT; Haag-Streit USA), TonoPen XL (Reichert Inc), Pascal Dynamic Contour tonometer (PDCT; Swiss Microtechnology AG), and Ocular Response Analyzer (ORA; Reichert Inc) and to analyze effects and correlation of corneal thickness and curvature on these measurements. DESIGN: Prospective, cross-sectional study. SETTINGS: Departments of Ophthalmology, University of Auckland and Auckland District Health Board, New Zealand. STUDY POPULATION: Thirty-one eyes of 31 participants with previous PK. OBSERVATIONS: IOP measured using GAT, TonoPen, PDCT, and ORA. Central corneal thickness (CCT) and corneal astigmatism were assessed by Pentacam rotating Scheimpflug tomography. MAIN OUTCOME MEASURE: Degree of agreement in IOP measures and correlation with CCT and corneal astigmatism. RESULTS: Mean age was 44.5 ± 21.0 years and mean time since PK was 27.7 ± 28.2 months (range 3.0-122.4 months). Mean CCT was 585 ± 149 μm and mean corneal astigmatism 5.5 ± 3.8 diopters. There was no significant difference in IOP measured by GAT and TonoPen; however, both PDCT (2.12 mm Hg, P < .01) and ORA (6.29 mm Hg, P < .01) measured significantly higher IOPs compared to GAT. ORA showed the least agreement with GAT. Significant correlation was identified between each pair of measurement techniques. No instruments correlated significantly with CCT. Only PDCT showed no significant correlation with corneal astigmatism. However, no IOP measures correlated with corneal astigmatism if sutures in situ or less than 1 year post-PK. CONCLUSIONS: TonoPen or PDCT are the most suitable alternatives for measuring IOP in PK eyes where GAT readings are difficult to obtain. PDCT also offers the advantage of being independent of both CCT and corneal astigmatism.
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