A comparison of intraocular pressure values obtained with the Tono-Pachymeter NT530P, iCare® rebound tonometer and Goldmann applanation tonometer

Abstract

The purpose of this study was to compare the intraocular pressure (IOP) values measured with the Tono-Pachymeter NT530P (Tonopachy™) and the iCare® rebound tonometer (iCare®) with those obtained by the Goldmann applanation tonometer (GAT). The right eyes of 105 subjects aged 18 to 82 years (mean age = 29.27 ± 14.67 years) were assessed with the three tonometers. Central corneal thickness (CCT) was measured first using the Tonopachy™ and then IOP was measured by Tonopachy™, iCare® and GAT. The data was analyzed with descriptive statistics, paired  t-test, correlation and regression analysis. The Bland-Altman method of analysis was used to evaluate agreements between the sets of data from the three devices. The CCT values ranged from 440 µm to 606 µm (mean= 518.49 ± 33.01 µm). There was little or no correlation between CCT and IOP for any of the instruments used in this study (r = 0.29 for Tonopachy™, r = 0.22 for iCare®, r = 0.17 for GAT). The mean IOP measured with the Tonopachy™ was 14.31 ± 3.57 mmHg (range 8.7 mmHg to 31 mmHg) and 16.64 ± 4.38 mmHg (range 8 mmHg to 32 mmHg) using the iCare®. The mean IOP measured with the GAT was 14.79 ± 3.09 mmHg (range 8.7 mmHg to 29.7 mmHg). Using the Bland-Altman method, the upper and lower limits of agreement between the Tonopachy™ and GAT, iCare® and GAT, iCare® and Tonopachy™ were 5.1 mmHg and –4.2 mmHg, 8.6 mmHg and –4.9 mmHg, 7.5 mmHg and –2.8 mmHg respectively. In 79.1% of the eyes studied, the mean IOP difference between Tonopachy™ and GAT was less than 3 mmHg and in 20.9% of the eyes, the difference was greater than 3 mmHg. However, mean IOP differences of greater than 3 mmHg were obtained by iCare® in comparison with GAT (40%) and Tonopachy™ (34.3%) respectively. Findings of this study suggest that the Tonopachy™ yielded IOP readings that were consistent with those of GAT values while iCare® yielded higher IOP values compared to both GAT and Tonopachy™. (S Afr Optom 2011 70(3) 109-116)