Transpalpebral tonometry as a priority method for intraocular pressure monitoring in corneal pathology

Abstract

BACKGROUND: Measurement of intraocular pressure in the presence of combined ophthalmic condition could determine further therapy and prognosis. However, tonometry in corneal diseases could lead to unreliable results. The search for methods for intraocular pressure measurement in these settings is a critical task intended to expand diagnostic capabilities. AIM: Evaluation of the transpalpebral tonometry diagnostic value for intraocular pressure monitoring in patients with corneal conditions of various origin. MATERIALS AND METHODS: Measurements of intraocular pressure were carried out in 39 patients with glaucoma and/or cataract (mean age 62.34 9.1), with corneal changes due to various ophthalmic conditions: post-traumatic scars; keratotomy scars as a result of refractive surgery; corneal defects due to ulcerative process of various etiology; corneal erosions; bullous keratopathy; deformities and leukomas after surgical treatment of pterygium or exposure to an infectious agent. Intraocular pressure measurement was carried out using several methods: palpation, using rebound and transpalpebral tonometry, in some cases tonometry was performed according to Maklakov method. RESULTS: The averaged data were comparable: palpation; rebound tonometry 23.34 4.7 mm Hg; transpalpebral tonometry 24.27 4.7 mm Hg; and Maklakov tonometry 23.16 5.4 mm Hg. The accuracy and reproducibility of measurement results increased significantly with the improvement of skills in using tonometers. CONCLUSIONS: Transpalpebral tonometry using TVGD-02 tonometer makes it possible to adequately assess intraocular pressure in patients with corneal pathology. The absence of contact during the implementation of technique makes it possible to recognize it as a priority when measuring intraocular pressure in certain categories of patients.