Tonometry in keratoconus
DOI: 10.32364/2311-7729-2024-24-1-7
V.V. Averich, A.V. Volzhanin
Krasnov Research Institute of Eye Diseases, Moscow, Russian Federation
Measurement of intraocular pressure (IOP) in keratoconus is associated with significant difficulties. Thus, because of corneal protrusion and changes in its biomechanics, the most common method of IOP measurement, applanation tonometry, provides significant error. The emergence of novel methods that are less dependent on corneal biomechanics has partially eliminated this error. These methods include tonometry based on new principles and dynamic contour tonometry. One of the "gold standards" for IOP measurement is Goldmann tonometry. Most foreign studies compare Goldman tonometry and one or more of the above-mentioned novel methods. However, in keratoconus, Goldman tonometry underestimates the IOP level and is therefore non-informative. Few studies compare IOP measurements and Maklakov tonometry. Finally, very few studies have compared IOP measurements at various stages of keratoconus, and their results are controversial. Comparing tonometry at different stages of keratoconus and studying fundamental changes in the hydrodynamics in keratoconus are relevant tasks in ophthalmology today.
Keywords: cornea, keratoconus, tonometry, intraocular pressure, hydrodynamics, gold standard.
For citation: Averich V.V., Volzhanin A.V. Tonometry in keratoconus. Russian Journal of Clinical Ophthalmology. 2024;24(1):36–40 (in Russ.). DOI: 10.32364/2311-7729-2024-24-1-7.
About the authors:
Veronika V. Averich — C. Sc. (Med.), junior researcher of the Department of Refractive Errors, Krasnov Research Institute of Eye Diseases; 11A, Rossolimo str., Moscow, 119021, Russian Federation; ORCID iD 0000-0001-5778-4123.
Andrey V. Volzhanin — C. Sc. (Med.), junior researcher of the Department of Glaucoma, Krasnov Research Institute of Eye Diseases; 11A, Rossolimo str., Moscow, 119021, Russian Federation; ORCID iD 0000-0002-1421-8882.
Contact information: Veronika V. Averich, e-mail: veronikky@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 10.11.2023.
Revised 01.12.2023.
Accepted 22.12.2023.
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7. McCafferty S.J., Enikov E.T., Schwiegerling J., Ashley S.M. Goldmann tonometry tear film error and partial correction with a shaped applanation surface. Clin Ophthalmol. 2018;12:71–78. DOI: 10.2147/OPTH.S152492.
8. Stodtmeister R., Kron M., Gaus W. IOP measurement and central corneal thickness. Br J Ophthalmol. 2002;86(1):120–121. DOI: 10.1136/bjo.86.1.120.
9. Kohlhaas M., Boehm A.G., Spoerl E. et al. Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol. 2006;124(4):471–476. DOI: 10.1001/archopht.124.4.471.
10. Tonnu P.A., Ho T., Newson T. et al. The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry. Br J Ophthalmol. 2005;89(7):851–854. DOI: 10.1136/bjo.2004.056622.
11. Аветисов С.Э., Петров С.Ю., Бубнова И.А. и др. Влияние центральной толщины роговицы на результаты тонометрии (обзор литературы). Вестник офтальмологии. 2008;124(5):1–7. [Avetisov S.E., Petrov S.Yu., Bubnova I.A. et al. Influence of central corneal thickness on the results of tonometry (review). Vestnik Oftalmologii. 2008;124(5):1–7 (in Russ.)].
12. Roberts C.J. Importance of accurately assessing biomechanics of the cornea. Curr Opin Ophthalmol. 2016;27(4):285–291. DOI: 10.1097/ICU.0000000000000282.
13. Маложен С.А., Белоусова Е.В. Современные возможности измерения офтальмотонуса при патологических состояниях и после оперативных вмешательств на роговице. Глаукома. Журнал НИИ ГБ РАМН. 2010;9(3):55–60. [Malozhen S.A., Beloysova E.V.The modern iop measurement approaches in patients with corneal diseases and after penetrating keratoplasty. Glaukoma. Zhurnal NII GB RAMN. 2010;9(3):55–60 (in Russ.)].
14. Kaushik S., Pandav S.S. Ocular Response Analyzer. J Curr Glaucoma Pract. 2012;6(1):17–19. DOI: 10.5005/jp-journals-10008-1103.
15. Herber R., Ramm L., Spoerl E. et al. Assessment of corneal biomechanical parameters in healthy and keratoconic eyes using dynamic bidirectional applanation device and dynamic Scheimpflug analyzer. J Cataract Refract Surg. 2019;45(6):778–788. DOI: 10.1016/j.jcrs.2018.12.015.
16. Kanngiesser H.E., Kniestedt C., Robert Y.C. Dynamic contour tonometry: presentation of a new tonometer. J Glaucoma. 2005;14(5):344–350. DOI: 10.1097/01.ijg.0000176936.16015.4e.
17. Труфанов С.В., Маложен С.А., Антонов А.А., Макарова М.А. Современные возможности офтальмотонометрии при патологических изменениях роговицы. Вестник офтальмологии. 2022;138(1):71–77. DOI: 10.17116/oftalma202213801171. [Trufanov S.V., Malozhen S.A., Antonov A.A., Makarova M.A. Modern capabilities of ophthalmic tonometry in pathologically altered corneas. Vestnik Oftalmologii. 2022;138(1):71–77 (in Russ.)]. DOI: 10.17116/oftalma202213801171.
18. Schädle N., Unterlauft J.D., Klink T., Geerling G. Evaluation of dynamic contour tonometry in keratoconus. Ophthalmologe. 2009;106(6):531–535. DOI: 10.1007/s00347-008-1812-1.
19. Firat P.G., Orman G., Doganay S., Demirel S. Influence of corneal parameters in keratoconus on IOP readings obtained with different tonometers. Clin Exp Optom. 2013;96(2):233–237. DOI: 10.1111/cxo.12016.
20. Klamann M.K., Maier A.K., Gonnermann J. et al. Influence of corneal thickness in keratoconic corneas on IOP measurement with IOPen, iCare, dynamic contour tonometry and Goldmann applanation tonometry. Klin Monbl Augenheilkd. 2013;230(7):697–700. DOI: 10.1055/s-0032-1328408.
21. Bayer A., Sahin A., Hurmeric V., Ozge G. Intraocular pressure values obtained by ocular response analyzer, dynamic contour tonometry, and goldmann tonometry in keratokonic corneas. J Glaucoma. 2010;19(8):540–545. DOI: 10.1097/IJG.0b013e3181ca7aeb.
22. Papastergiou G.I., Kozobolis V., Siganos D.S. Assessment of the pascal dynamic contour tonometer in measuring intraocular pressure in keratoconic eyes. J Glaucoma. 2008;17(6):484–488. DOI: 10.1097/IJG.0b013e3181622502.
23. Meyenberg A., Iliev M.E., Eschmann R., Frueh B.E. Dynamic contour tonometry in keratoconus and postkeratoplasty eyes. Cornea. 2008;27(3):305–310. DOI: 10.1097/ICO.0b013e31815dcf97.
24. Barreto J.Jr., Babic M., Vessani R.M., Susanna R.Jr. Dynamic contour tonometry and goldman applanation tonometry in eyes with keratoconus. Clinics (Sao Paulo). 2006;61(6):511–514. DOI: 10.1590/s1807-59322006000600004.
25. Zabek O., Panos G.D., Sagri D. et al. Intraocular Pressure Elevation in Keratoconus with Coexisting Pseudoexfoliation Glaucoma: How Important is the Method of Measurement? Klin Monbl Augenheilkd. 2020;237(4):392–395. DOI: 10.1055/a-1101-8918.
26. Nishida T., Kojima T., Kataoka T. et al. Evaluation of Biomechanically Corrected Intraocular Pressure Measurements in Keratoconus and Forme Fruste Keratoconus. Ophthalmic Res. 2020;63(6):541–549. DOI: 10.1159/000506839.
27. Alvani A., Hashemi H., Pakravan M. et al. Correction methods for noncontact intraocular pressure measurement in patients with keratoconus and healthy individuals. Arq Bras Oftalmol. 2022;85(5):490–497. DOI: 10.5935/0004-2749.20220072.
28. Wu Y., Li X.L., Yang S.L. et al. Examination and discriminant analysis of corneal biomechanics with CorVis ST in keratoconus and subclinical keratoconus. Beijing Da Xue Xue Bao Yi Xue Ban. 2019;51(5):881–886. DOI: 10.19723/j.issn.1671-167X.2019.05.015.
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