Citation Information :
Soares PH, Santos RD, Filho CR, Neto SP, Prata Junior JA. Goldmann Applanation Tonometry: Comparison of Intraocular Pressure Values Obtained with Disposable Tip and Conventional Applanation Prism in the Population without Clinical Signs of Glaucoma. J Curr Glaucoma Pract 2023; 17 (2):75-78.
Aim: Comparing intraocular pressure (IOP) measurements using Goldmann applanation prism and TonoSafe® in the population without signs of glaucoma.
Material and methods: Patients with no ocular pathologies, except ametropia (until ± 4 D) or IOP of <30 mm Hg without signs of glaucoma by optic disc structural analysis by fundus biomicroscopy. The IOP was measured sequentially using the traditional cone and the TonoSafe®, according to a randomization list to determine which device would be used first. The measurements from the right and left eyes were compared separately. Since there was no statistical difference, both eyes were considered in this study.
Results: A total of 385 eyes of 194 patients with a mean age of 66.4 ± 11.2 years old were included. The mean IOP with conventional prism was 14.2 ± 3.6 and 14.3 ± 3.6 mm Hg with TonoSafe®. Differences were not statistically significant by the Wilcoxon test (p = 0.3). The median was 14.0 mm Hg for both groups. The mean difference between measurements was 0.04 mm Hg, with the median equal to zero. There was no statistical difference in IOP readings according to which device was the first measurement.
Conclusion: No statistical difference was found in IOP was measured with conventional prism or TonoSafe® in the population without signs of glaucoma.
Clinical significance: The data provided by our study support the efficacy and safety of the disposable tonometer compared to the Goldman tonometer in measuring IOP in patients without glaucoma.
Karadag R, Kayiran A, Rapuano CJ. Does the novel coronavirus use the ocular surface as an entrance into the body or as an infection site? Arq Bras Oftalmol 2022;85(1):92–98. DOI: 10.5935/0004-2749.20220012
Junk AK, Chen PP, Lin SC, et al. Disinfection of tonometers: a report by the American Academy of Ophthalmology. Ophthalmology 2017;124(12):1867–1875. DOI: 10.1016/j.ophtha.2017.05.033
Ragan A, Cote SL, Huang JT. Applanation tonometer disinfection: a national benchmarking study. Can J Ophthalmol 2017;52(2):e46–e49. DOI: 10.1016/j.jcjo.2016.09.001
Atkins N, Hodge W, Li B. A systematic review regarding tonometry and the transmission of infectious diseases. J Clin Med Res 2018;10(3):159–165. DOI: 10.14740/jocmr3294w
Ragan A, Cote SL, Huang JT. Disinfection of the Goldman applanation tonometer: a systematic review. Can J Ophthalmol 2018;53(3):252–259. DOI: 10.1016/j.jcjo.2017.09.013
Segal WA, Pirnazar JR, Arens M, et al. Disinfection of Goldmann tonometers after contamination with hepatitis C virus. Am J Ophthalmol 2001;131(2):184–187. DOI: 10.1016/s0002-9394(00)00784-4
Koo D, Bouvier B, Wesley M, et al. Epidemic keratoconjunctivitis in a university medical center ophthalmology clinic; need for re-evaluation of the design and disinfection of instruments. Infect Control Hosp Epidemiol 1989;10(12):547–552. DOI: 10.1086/645949
Cheung D, Bremner J, Chan JT. Epidemic kerato-conjunctivitis–do outbreaks have to be epidemic? Eye (Lond). 2003;17(3):356–363. PMID: 12724699. DOI: 10.1038/sj.eye.6700330
Zeri F, Lupelli L, Formichella P, et al. Goldmann applanation tonometry over daily disposable contact lens: accuracy and safety of procedure. Cont Lens Anterior Eye 2007;30(4):233–238. DOI: 10.1016/j.clae.2007.06.001
Guideline for Disinfection and Sterilization in. Healthcare Facilities, [Internet]. CDC. 2008 [cited 2016]. Available from: www.cdc.gov/hicpac/Disinfection_Sterilization/3_1deLaparoArthro.html.
Cook JA, Botello AP, Elders A, et al. Systematic review of the agreement of tonometers with Goldmann applanation tonometry. Ophthalmology 2012;119(8):1552–1557. DOI: 10.1016/j.ophtha.2012.02.030
Omar Akhtar A, Singh H, Si F, et al. A systematic review and cost-effectiveness analysis of tonometer disinfection methods. Can J Ophthalmol 2014;49(4):345–350. DOI: 10.1016/j.jcjo.2014.04.003
Manual de Instruções Tonometro de Goldmann. [Internet]. Haag-Streit Diagnostics 2015 [cited 2016]. Available from: http://www.haag-streit.com/haag-streit-diagnostics/products/tonometry/at-900/.
List of disinfectants for tonometer measuring prisms and contact glasses (Studies Publications) [Internet]. Haag Streit Diagnostics. 2015. Available from: http://www.haag-streit.com/haag-streit-diagnostics/products/tonometry/at-900/.
Instructions for use and disinfection of tonometer measuring prisms [Internet]. Carl Zeiss-Meditec. 2015 [cited 2016]. Available from: http://www.zeiss.com/meditec/en_de/products---solutions/ophthalmology-optometry/essential-line-basic-diagnostics/iop-and-retina-screening/applanation-tonometer.html#downloads.
Kim P, Lertsumitkul S, Clark M, et al. Accuracy of the Tonosafe disposable tonometer head compared to the Goldmann tonometer alone. Clin Experiment Ophthalmol 2004;32(4):364–367. DOI: 10.1111/j.1442-9071.2004.00838.x
Bhatnagar A, Gupta AK. Disposable devices for measuring intraocular pressure: a clinical study to assess their accuracy. Eye (Lond) 2005;19(7):752–754. DOI: 10.1038/sj.eye.6701638
Salvi SM, Sivakumar S, Sidiki SS. Use of disposable prism tonometry in routine clinical practice. Eye (Lond) 2005;19(7):743–746. DOI: 10.1038/sj.eye.6701633
Maino AP, Morgan LH, Hercules BL, et al. Are disposable prisms an adequate alternative to standard Goldmann tonometry prisms in glaucoma patients? Ophthalmology 2006;113(10):1837–1841. DOI: 10.1016/j.ophtha.2006.05.031
Rajak SN, Paul J, Sharma V, et al. Contamination of disposable tonometer prisms during tonometry. Eye (Lond) 2006;20(3):358–361. DOI: 10.1038/sj.eye.6701866
A Guide to Goldmann Reusable Prisms [Internet]. Haag-Streit USA. 2013. Available from: http://www.haag-streit.com/fileadmin/Haag-Streit_USA/Diagnostics/tonosafe/download/Prism-Checking-USA.pdf.
Jasani KM, Putri C, Pearl A, et al. Disposable versus non-disposable tonometer prisms: a UK national survey. BMJ Open Ophthalmol 2017;1(1):e000019. DOI: 10.1136/bmjophth-2016-000019
Wong B, Parikh D, Rosen L, et al. Comparison of disposable Goldmann applanation tonometer, ICare ic100, and Tonopen XL to standards of care Goldmann nondisposable applanation tonometer for measuring intraocular pressure. J Glaucoma 2018;27(12):1119–1124. DOI: 10.1097/IJG.0000000000001059
Goel S, Chua C, Dong B, et al. Comparison between standard Goldmann applanation prism and disposable applanation prism in tonometry. Eye (Lond) 2004;18(2):175–178. DOI: 10.1038/sj.eye.6700553
Thomas V, Daly MK, Cakiner-Egilmez T, et al. Reliability of tonosafe disposable tonometer prisms: clinical implications from the Veterans Affairs Boston Healthcare System Quality Assurance Study. Eye (Lond) 2011;25(5):651–656. DOI: 10.1038/eye.2011.40
Ajtony C, Elkarmouty A, Barton K, et al. Applanation tonometry: interobserver and prism agreement using reusable Goldmann applanation prim and Tonosafe disposable prism. Br J Ophthalmol 2016;100(6):848–853. DOI: 10.1136/bjophthalmol-2015-307240
Tsai AS, How AC, Su DH, et al. Comparison of applantion tonometry using conventional reusable Goldmann prisms and disposable prisms. J Glaucoma 2014;23(8):521–525. DOI: 10.1097/IJG.0b013e318294863d