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Christoph Kniestedt, MD; Shan Lin, MD; Joyce Choe, MD; Alan Bostrom, PhD; Michelle Nee, MD; Robert L. Stamper, MD

Arch Ophthalmol. 2005;123:1532-1537.

Objectives  To compare intraocular pressure readings of recently introduced dynamic contour tonometry (DCT) with pneumatonometry (PTG) and Goldmann applanation tonometry (GAT) and to correlate central corneal thickness (CCT) with these readings.

Design  Prospective, cross-sectional observation and instrument validation study. We included 258 independent eyes with normal anterior segment examinations results, irrespective of glaucoma diagnosis or glaucoma suspect. After pachymetry, DCT, PTG, and GAT were performed in a randomized order. Intraocular pressures as measured by DCT, PTG, and GAT were compared with each other and with CCT.

Results  Eyes with thinner CCTs tended to yield lower intraocular pressure measurements by GAT. A significant correlation (Pearson product moment correlation, P<.001) between CCT and GAT was found with a regression of 0.25 mm Hg per 10 µm (R² = 0.060). Variation of CCT had no significant effect on intraocular pressure measurements by PTG (P = .10; R² = 0.01) and DCT (P = .80; R²<0.01). A piecewise regression model showed that GAT readings are not linearly correlated with CCT. Comparison of the slopes below and above 535 µm showed the highest significance (P<.001).

Conclusions  Goldmann applanation tonometry readings are potentially influenced by CCT, whereas PTG and DCT seem to be less dependent on CCT. Correlation between CCT and GAT is not linear. A simple correction formula suggesting a linear relationship might not be correct.

Author Affiliations: Departments of Ophthalmology (Drs Kniestedt, Lin, Choe, Nee, and Stamper) and Epidemiology and Biostatistics (Dr Bostrom), University of California–San Francisco; and Departments of Ophthalmology, Cantonal Hospital Winterthur, Winterthur, Switzerland (Dr Kniestedt), and University Hospital Zurich, Zurich, Switzerland (Dr Kniestedt).

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