Clinical Ophthalmology (Nov 2023)
Assessing Agreement and Variability Among Alternative Devices for Intraocular Pressure Measurement: A Comparative Study
Abstract
Chen-Wei Lin,1,2,* Jin-Jhe Wang,2,* Chien-Hsiung Lai,2– 5 Chau-Yin Chen,2,3 Ing-Chou Lai2,3,6 1Department of Medical Education, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan; 2Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan; 3Department of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan; 4Department of Nursing, Chang Gung University of Science and Technology, Chiayi, 61363, Taiwan; 5School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan; 6Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 83301, Taiwan*These authors contributed equally to this workCorrespondence: Jin-Jhe Wang, Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, No. 8, Sec. W., Jiapu Road, Puzi City, Chiayi County, 613, Taiwan, Tel +886 5 3621000, Fax +886 5 3623002, Email [email protected]: Intraocular pressure (IOP) measurement is critical in diagnosing and managing eye conditions. This study aims to assess the comparability of three alternative devices for measuring IOP: Noncontact tonometer, Icare rebound tonometer, and Tono-Pen.Patients and Methods: A cross-sectional study included 172 adult participants (87 males and 85 females) who underwent IOP and central corneal thickness (CCT) assessments. IOP was measured using Noncontact (Canon TX-20), Icare (Icare TA01i), and Tono-Pen (Tonopen XL). CCT was measured with the built-in pachymetry of the Noncontact tonometer. Correlation coefficients and Bland-Altman analyses were conducted to assess the relationships and agreements between these tonometers. Participants were grouped based on IOP and CCT levels. The mean of the standard deviation of the three tonometer results was calculated to evaluate measurement result variability. One-way analysis of variance was conducted for comparing between the groups.Results: IOP measurements among the three devices were not significantly different, indicating their comparability. Correlation analysis revealed strong correlations between the tonometers. Bland-Altman analysis showed good agreement, with the Icare rebound tonometer and Tono-Pen exhibiting narrower limits of agreement. Furthermore, IOP levels influenced measurement result variability, with higher IOP levels associated with greater variance.Conclusion: This study demonstrates that the alternative devices examined can provide reliable IOP measurements. It highlights the potential of these alternative devices for IOP measurement. These findings have implications for clinical practice, offering practitioners additional tools for accurate IOP assessment.Keywords: intraocular pressure, tonometer, noncontact, icare, Tono-Pen
