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Impressum
Determination of central corneal thickness in glaucoma diagnostics does not improve the accuracy of applanation tonometry
Bau V., Scheffler A., Giessler S., Wilhelm F.
Klinik und Poliklinik für Augenheilkunde Halle-Wittenberg
Background: In different studies the central corneal thickness
influences the applanation tonometry. It seems, that in thinner corneas
the applanation tonometry underestimates, in thicker corneas overestimates
the intraocular pressure. Attempts to quantify the correction factor gave
different results.
Methods: We examined 16 patients before cataract extraction: 1.Central
corneal thickness (by ultrasound pachymetry and optically by Orbscan)
2.Intraocular pressure by applanation tonometry (Perkins-Tonometer) 3.Intraocular
pressure measured directly in the eye (Fa. Geuder).
Results: Optical
and ultrasound pachymetry showed a very high correlation (p<0,001).
On average the intraocular pressure was 0,5mmHg (SD 5,7mmHg, minimum -12mmHg,
maximum 8mmHg) lower when measured by applanation tonometry than measured
intraocularly. There was no significant relation between the difference
of IOD obtained by the two methods and the central corneal thickness (linear
simple regression: p=0,815 optical pachymetry, p=0,858 ultrasoundpachymetry).
Conclusions: The error
of applanation tonometry is relatively low. It seems to be not relevant
for clinical routine. However, it might be useful in individual cases
to control the pressure directly intraocular, especially when intraocular
pressure is obviously inconsistent to the clinical symptoms. The central
corneal thickness, however, isn´t helpful to improve the accuracy
of applanation tonometry because there seems not to be statistically significant
relation between the parameters.