الفهرس | Only 14 pages are availabe for public view |
Abstract Intraocular pressure (IOP) is the fluid pressure in the eye mainly related to aqueous humor which is secreted by the ciliary process to the posterior chamber and goes through the pupil to the anterior chamber (inflow). It then leaves the anterior chamber through the trabecular meshwork to the venous system (outflow). Normally, there is equilibrium between inflow and outflow that creates normal intraocular pressure (IOP). The measurement of intraocular pressure (IOP) is an essential examination in daily ophthalmic procedures, also is a fundamental tool in the management and follow-up of glaucoma patients. Many factors, such as central corneal thickness (CCT), corneal astigmatism and biomechanical properties of the cornea can affect the accuracy of IOP measurement. Elevated intraocular pressure (IOP) is a major risk factor for the development and progression of glaucoma. Therefore, IOP measurements provide important information to clinicians about glaucoma diagnosis, assessing the possibility of progression, and monitoring the clinical response to therapy. Goldmann applanation tonometry (GAT) is considered as a worldwide accepted gold standard for IOP measurement in clinical practice. Recently, several new methods have been devised, in order to make the IOP measurement faster and more comfortable. Another applanation device is a non-contact tonometer (NCT; Nidek Co., Ltd., Aichi, Japan), also called an Air-Puff tonometer. An NCT uses air to flatten the cornea instead of touching it. The iCare rebound tonometer (iCare, Helsinki, Finland) is a new technique for IOP measurements. A very light probe is launched against the corneal surface to make fleeting contact and spring back from the cornea. The Summary and Conclusion 76 deceleration of the probe is calculated into the IOP and displayed on the device after six rebounds per measurement. Due to its comfortableness and ease of use, iCare tonometer has gained much attention in clinical practice. This study aimed to compare Intraocular pressure measurements using three different tools, Goldmann Tonometer, Air-Puff Tonometer and iCare Tonometer in normal subjects, glaucomatous patients and patients after refractive surgery. This cross-sectional study was conducted on 102 of the patients attending the outpatient clinic of Ophthalmology department Menoufia University. The cases were divided into three equal groups: group I (control group): included normal subjects as a control group. group II (Glaucoma group): included glaucomatous patients on medical treatment. group III (Refractive group): included subjects after refractive surgery. Summary of our results: No significant differences were found between all studied groups regarding gender. iCare Tonometer was significantly lower in Lasik when compared to control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides. Air-Puff Tonometer was significantly lower in Lasik when compared to control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides. Summary and Conclusion 77 Goldmann Tonometer was significantly lower in Lasik when compared to control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides. IOP was measured by different methods. It was noticed that Goldmann had lower measures in the three groups. IOP measures by Goldmann Tonometer and iCare Tonometer did not differ significantly among all studied groups. IOP measures by iCare Tonometer and Air-Puff Tonometer did not differ significantly among all studied groups. IOP measures by Goldmann Tonometer and Air-Puff Tonometer differed significantly among all studied groups. Mean differences in IOP between Air-Puff and Goldmann Tonometers was 2.6, while it was 1.12 between iCare and Goldmann Tonometer and 1.5 between iCare and Air-Puff Tonometer. Inter class correlation between all studied methods was strong. CCT was significantly lower in Lasik when compared to control (p3<0.05) and glaucoma (p4<0.05) groups on right and left sides. CCT showed significant positive correlations with age, IOP by iCare Tonometer, Air-Puff Tonometer, Goldmann Tonometer. |