Journal of Current Glaucoma Practice

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VOLUME 12 , ISSUE 1 ( 2018 ) > List of Articles

RESEARCH ARTICLE

Citius, Altius, Fortius: Agreement between Perkins and Dynamic Contour Tonometry (Pascal) and the Impact of Altitude

Shibal Bhartiya, Oscar Albis-Donado, Giovanna Casale-Vargas, Marina Gil-Reyes, Nancy Arreguin-Rebollar, Malik Y Kahook

Keywords : Atmospheric pressure, Bias, Glaucoma, Tonometry.

Citation Information : Bhartiya S, Albis-Donado O, Casale-Vargas G, Gil-Reyes M, Arreguin-Rebollar N, Kahook MY. Citius, Altius, Fortius: Agreement between Perkins and Dynamic Contour Tonometry (Pascal) and the Impact of Altitude. J Curr Glaucoma Pract 2018; 12 (1):40-44.

DOI: 10.5005/jp-journals-10028-1242

License: CC BY 4.0

Published Online: 00-04-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: To ascertain differences in intraocular pressure (IOP) measurement and their repeatability between dynamic contour tonometry (DCT) and Goldmann/Perkins applanation tonometry (GAT) at two different atmospheric pressures. Materials and methods: Forty-one eyes of 41 healthy consenting subjects were enrolled for this observational, crosssectional study. Pachymetry and IOP measurements with DCT and GAT for both eyes of each subject at Acapulco (0 m from sea level) and at Mexico City (2,234 m from sea level) were done by the same observer. The IOP was compared between tonometers at each of the altitudes, and also for repeatability of each tonometer at different altitudes. Pearson\'s correlation coefficient and Bland–Altman plots were used to assess reliability of measurements and their differences at the two altitudes. Results: The mean age of patients was 41.7 (28–66 years); 22 were females. Mean IOP with DCT was 16.1 ± 2.2 mm Hg at sea level and 15.9 ± 2.1 mm Hg at 2,234 m above sea level, not a significant difference. Mean GAT IOP at the two altitudes was 13.1 ± 1.8 and 11.5 ± 1.7 mm Hg respectively, a statistically significant difference. In contrast, central corneal thickness (CCT) was not significantly changed (548.3 to 549.4 ìm, p = 0.496). Conclusion: Repeatability of single-observer measurements with GAT remains clinically acceptable, but not at different altitudes. The DCT seems to more consistently measure a similar IOP at different altitudes in the same subjects. The two tonometers may not be used interchangeably in the serial follow-up of patients at any of the altitudes.


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