Einflussgrößen auf die Applanationstonometrie – ein praxisorientierter Überblick

Zusammenfassung

Die Applanationstonometrie stellt in der klinischen Praxis seit über 50 Jahren den Goldstandard dar. Der mittlerweile bekannteste Einflussfaktor, die zentrale Hornhautdicke, wird inzwischen allgemeinhin in der Glaukomdiagnostik berücksichtigt, auch wenn sicherlich noch andere individuelle Charakteristika der Hornhaut eine wichtige Rolle für die Interpretation der Applanationswerte spielen. Viele weitere Einflussfaktoren (Tränenfilm, Fluoreszeinmenge etc.) sind seit Jahrzehnten bekannt, sollten aber immer wieder vergegenwärtigt werden. Auch die unkorrekte Kalibrierung des Applanationstonometers ist nach derzeitiger Datenlage eine nicht zu vernachlässigende Fehlerquelle.

Abstract

Applanation tonometry has been the gold standard in clinical ophthalmology for more than fifty years. The most popular factor is central corneal thickness that is now routinely considered in glaucoma management. However, other individual features of the cornea can also play a key role for the interpretation of the applanation values. Other factors influencing applanation tonometry that have been well known for decades include tear film, fluorescein illumination etc., and should be kept in mind. According to the available literature the absence of a correct calibration cannot be neglected.

Schlüsselwörter

Glaukom - Applanationstonometrie - Messfehler - Augeninnendruck

Key words

glaucoma - applanation tonometry - measurement errors - intraocular pressure

Literatur

• 1 Goldmann H, Schmidt T. Über Applanationstonometrie.  Ophthalmologica. 1957;  134 221-242
• 2 Goldmann H. Un nouveau tonomètre d’applanation.  Bull Soc Ophthalmol Fr. 1955;  67 474-478
• 3 International Standards Organization .ISO8612:2001(E): Ophthalmic instruments – tonometers. Geneva: ISO Copyright Office; 2001
• 4 Thorburn W. The accuracy of clinical applanation tonometry.  Acta Ophthalmol. 1978;  56 1-5
• 5 Phelps C D, Phelps G K. Measurement of intraocular pressure: a study of its reproducibility.  Graefe’s Arch Clin Exp Ophthalmol. 1976;  198 39-43
• 6 Moses R A. The Goldmann applanation tonometer.  Am J Ophthalmol. 1958;  46 865-869
• 7 Purcell J J, Tillery W. Hair glaucoma. Correspondence.  Arch Ophthalmol. 1973;  89 530
• 8 Ritch R, Reyes A. „Moustache glaucoma”. Correspondence.  Arch Ophthalmol. 1988;  106 1505
• 9 Whitacre M M, Stein R. Sources of Error with use of Goldmann-type tonometers.  Surv Ophthalmol. 1993;  38 1-30
• 10 Whitacre M M, Emig M, Hassanein K. The effect of Perkins, Tono-Pen, and Schiötz tonometry on intraocular pressure.  Am J Ophthalmol. 1991;  111 59-64
• 11 Wilke K. Effects of repeated tonometry: genuine and sham measurements.  Acta Ophthalmol. 1972;  50 574-582
• 12 Choudhari N S, George R, Baskaran M et al. Measurement of Goldmann applanation tonometer calibration error.  Ophthalmology. 2009;  116 3-8
• 13 Kumar N, Jivan S. Goldmann applanation tonometer calibration error checks: current practice in the UK.  Eye. 2007;  21 733-734
• 14 Broman A T, Congdon N G, Bandeen-Roche K et al. Influence of corneal structure, corneal responsiveness, and other ocular parameters on tonometric measurement of intraocular pressure.  J Glaucoma. 2007;  16 581-588
• 15 Chihara E. Assessment of true intraocular pressure: the gap between theory and practical data.  Surv Ophthalmol. 2008;  53 203-218
• 16 Rask G, Behndig A. Effects of corneal thickness, curvature, astigmatism and direction of gaze on goldmann applanation tonometry readings.  Ophthalmic Res. 2006;  38 49-55
• 17 Kaufman H E, Wind C A, Waltman S R. Walidity of Mackay-Marg electronic applanation tonometer in patients with scarred irregular corneas.  Am J Ophthalmol. 1970;  69 1003-1007
• 18 Kaufman H E. Pressure measurement: Which tonometer?.  Invest Ophthalmol. 1972;  11 80-85
• 19 Doughty M J, Zaman M L. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach.  Surv Ophthalmol. 2000;  44 367-408
• 20 Ehlers N, Bramsen T, Sperling S. Applanation tonometry and central corneal thickness.  Acta Ophthalmol. 1975;  53 34-43
• 21 Whitacre M M, Stein R A, Hassanein K. The effect of corneal thickness on applanation tonometry.  Am J Ophthalmol. 1993;  115 592-596
• 22 Kohlhaas M, Boehm A G, Spoerl E et al. Effect of central corneal thickness, corneal curvature, and a legth on applanation tonometry.  Arch Ophthalmol. 2006;  124 471-476
• 23 Aristeidou A P, Labiris G, Katsanos A et al. Comparison between Pascal dynamic contour tonometer and Goldmann applanation tonometer after different types of refractive surgery.  Graefes Arch Clin Exp Ophthalmol. 2010;  ; Epub ahead of print
• 24 Zadok D, Raifkup F, Landao D et al. Intraocular pressure after LASIK for hyperopia.  Ophthalmology. 2002;  109 1659-1661
• 25 Romppainen T, Bachmann L M, Kaufmann C et al. Effect of riboflavin-UVA-induced collagen cross-linking on intraocular pressure measurement.  Invest Ophthalmol Vis Sci. 2007;  48 5494-5498
• 26 Kymionis G D, Grentzelos M A, Kounis G A et al. Intraocular pressure measurements after corneal collagen crosslinking with riboflavin and ultraviolet A in eyes with keratoconus.  J Cataract Refract Surg. 2010;  36 1724-1727
• 27 Teng C, Gurses-Ozden R, Liebmann J M et al. Effect of a tight necktie on intraocular pressure.  Br J Ophthalmol. 2003;  87 946-948
• 28 Theelen T, Meulendijks C FM, Geurts D EM et al. Impact factors on intraocular pressure measurements in healthy subjects.  Br J Ophthalmol. 2004;  88 1510-1511
• 29 dos Santos M G, Makk S, Berghold A et al. Intraocular pressure difference in Goldmann applanation tonometry versus Perkins hand-held applanation tonometry in overweight patients.  Ophthalmology. 1998;  105 2260-2263
• 30 Rosen D A, Johnston V C. Ocular pressure patterns in the Valsalva maneuver.  Arch Ophthalmol. 1959;  62 810-816
• 31 Allen R J, Dev Borman A, Saleh G M. Applanation tonometry in silicone hydrogel contact lens wearers.  Cont Lens Anterior Eye. 2007;  30 267-269
• 32 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;  30 233-238
• 33 Draeger J. Applanationstonometrie auf Kontaktlinsen mit hohem Wassergehalt. Probleme, Ergebnisse und Korekturfaktoren.  Klin Monatsbl Augenheilkd. 1980;  176 38-43
• 34 Hamilton K, Pye D, Hua S et al. The effect of contact lens induced oedema on the accuracy of Goldmann tonometry in a mature population.  Br J Ophthalmol. 2007;  91 1636-1638
• 35 Hamilton K E, Pye D C, Kao L et al. The effect of corneal edema on dynamic contour and goldmann tonometry.  Optom Vis Sci. 2008;  85 451-456