TY - JOUR
T1 - The utility of Diaton tonometer measurements in patients with ocular hypertension, glaucoma, and glaucoma tube shunts
T2 - A preliminary study for its potential use in keratoprosthesis patients
AU - Risma, Justin M.
AU - Tehrani, Shandiz
AU - Wang, Kai
AU - Fingert, John H.
AU - Alward, Wallace L.M.
AU - Kwon, Young H.
N1 - Publisher Copyright:
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Purpose: Glaucoma is common in patients with the Boston type 1 keratoprosthesis (KPro). Because of the inability to perform corneal applanation in KPro patients, digital palpation is currently the mainstay for assessment of intraocular pressure (IOP). The purpose of this study was to determine whether the Diaton tonometer, which estimates IOP through transpalpebral scleral indentation, can reasonably detect high IOP when compared with Goldmann applanation tonometry (GAT) in patients with ocular hypertension, glaucoma, or glaucoma tube shunts. If reliable in these patients, it may be helpful in patients with KPros. Materials and Methods: We prospectively measured IOP using GAT and Diaton transpalpebral tonometry (DTT) on the upper and lower eyelids in 87 eyes of 57 adult participants with ocular hypertension and glaucoma, several of whom had glaucoma tube shunts. Results: The correlation coefficient between GAT and DTT on the upper eyelid was 0.64 (P<0.0001). For detecting an IOP of >21mm Hg as measured by GAT, DTT on the upper eyelid had a sensitivity and specificity of 65% and 81%, respectively. The positive and negative predictive values were 74% and 73%, respectively. Bland-Altman analysis demonstrated limits of agreement of 2.0±19.5mm Hg for GAT versus DTT on the upper eyelid. The presence of a tube shunt did not significantly affect the results. Conclusions: Diaton tonometry has a large margin of error compared with GAT in patients with ocular hypertension, glaucoma, and glaucoma tube shunts. However, given the current lack of an objective and quantitative method of IOP measurement in KPro patients, Diaton tonometry may be useful in this population as a supplement to digital palpation.
AB - Purpose: Glaucoma is common in patients with the Boston type 1 keratoprosthesis (KPro). Because of the inability to perform corneal applanation in KPro patients, digital palpation is currently the mainstay for assessment of intraocular pressure (IOP). The purpose of this study was to determine whether the Diaton tonometer, which estimates IOP through transpalpebral scleral indentation, can reasonably detect high IOP when compared with Goldmann applanation tonometry (GAT) in patients with ocular hypertension, glaucoma, or glaucoma tube shunts. If reliable in these patients, it may be helpful in patients with KPros. Materials and Methods: We prospectively measured IOP using GAT and Diaton transpalpebral tonometry (DTT) on the upper and lower eyelids in 87 eyes of 57 adult participants with ocular hypertension and glaucoma, several of whom had glaucoma tube shunts. Results: The correlation coefficient between GAT and DTT on the upper eyelid was 0.64 (P<0.0001). For detecting an IOP of >21mm Hg as measured by GAT, DTT on the upper eyelid had a sensitivity and specificity of 65% and 81%, respectively. The positive and negative predictive values were 74% and 73%, respectively. Bland-Altman analysis demonstrated limits of agreement of 2.0±19.5mm Hg for GAT versus DTT on the upper eyelid. The presence of a tube shunt did not significantly affect the results. Conclusions: Diaton tonometry has a large margin of error compared with GAT in patients with ocular hypertension, glaucoma, and glaucoma tube shunts. However, given the current lack of an objective and quantitative method of IOP measurement in KPro patients, Diaton tonometry may be useful in this population as a supplement to digital palpation.
KW - Diaton
KW - Glaucoma
KW - Intraocular pressure
KW - Keratoprosthesis
UR - http://www.scopus.com/inward/record.url?scp=84960171870&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960171870&partnerID=8YFLogxK
U2 - 10.1097/IJG.0000000000000394
DO - 10.1097/IJG.0000000000000394
M3 - Article
C2 - 26950582
AN - SCOPUS:84960171870
SN - 1057-0829
VL - 25
SP - 643
EP - 647
JO - Journal of Glaucoma
JF - Journal of Glaucoma
IS - 8
ER -