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Significance of dynamic contour tonometry in evaluation of progression of glaucoma in patients with a history of laser refractive surgery
  1. Sang Yeop Lee,
  2. Eun Woo Kim,
  3. Wungrak Choi,
  4. Chan Keum Park,
  5. Sangah Kim,
  6. Hyoung Won Bae,
  7. Gong Je Seong,
  8. Chan Yun Kim
  1. Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  1. Correspondence to Dr Chan Yun Kim, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 134, Korea; kcyeye{at}yuhs.ac

Abstract

Aims In this study, we tested the hypothesis that intraocular pressure (IOP) parameters measured by dynamic contour tonometry (DCT) would be more relevant in progression of glaucoma when there is a history of laser refractive surgery (LRS) than the IOP parameters measured by Goldmann applanation tonometry (GAT) or calculated by correction formulae.

Methods Ninety-eight eyes in 54 patients with open-angle glaucoma and a history of LRS were included in this retrospective study. IOP was measured by both GAT and DCT during follow-up. Baseline, mean, and peak IOP, IOP fluctuation, and IOP reduction were measured by each tonometry method. Corrected IOP parameters using central corneal thickness and mean keratometry values were also analysed. Clustered logistic regression was used to identify variables correlated with progression of glaucoma. Areas under the curve (AUCs) for correlated variables were also compared.

Results The mean DCT value (OR 1.36, p=0.024), peak DCT value (OR 1.19, p=0.02) and pattern SD (OR 1.10, p=0.016) were significant risk factors for progression. There was a significant difference in the predictive ability of the mean DCT and GAT values (AUC 0.63 and 0.514, respectively; p=0.01) and of the peak DCT and GAT values (0.646 and 0.503, respectively, p=0.009). The AUCs for corrected IOP did not exceed those of DCT.

Conclusions IOP measurements were more associated with progression of glaucoma when measurements were obtained by DCT than by GAT or correction formulae in eyes with a history of LRS.

  • dynamic contour tonometry
  • glaucoma progression
  • laser refractive surgery
  • goldmann applanation tonometry
  • intraocular pressure

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Footnotes

  • Contributors Conception and design: SYL, CYK. Analysis and interpretation: SYL, GJS, CYK. Data collection: SYL, EWK, WC, CKP, SK. Overall responsibility: CYK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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