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Matthias C. Grieshaber, MD; Andreas Schoetzau, MS; Claudia Zawinka, MD; Josef Flammer, MD; Selim Orgul, MD

Arch Ophthalmol. 2007;125(6):740-744.

Objective  To compare the dependence of dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) on central corneal thickness (CCT) in primary open-angle glaucoma.

Methods  In a prospective study, the interocular (right vs left eye) difference in intraocular pressure measured by DCT and GAT was compared with the interocular CCT difference in 125 patients with primary open-angle glaucoma.

Results  Dynamic contour tonometry measurements (mean ± SD, 19.4 ± 4.1 mm Hg) were significantly (P = .004) higher than GAT measurements (mean ± SD, 15.5 ± 3.4 mm Hg), correlating significantly with each other (r² = 0.82, P<.001). The interocular difference in intraocular pressure correlated significantly with the interocular CCT difference for GAT (r = 0.30, P = .001) and DCT (r = 0.23, P = .02) readings. Dynamic contour tonometry and GAT intraocular pressure differences significantly increased with older age (slope, 0.033 [95% confidence interval, 0.002-0.064] mm Hg/y; P =.03) but not with thicker CCT (slope, 0.006 [95% confidence interval, –0.003 to 0.017] mm Hg/µm; P =.22).

Conclusions  In this series, GAT and DCT measurements were dependent on CCT in patients with primary open-angle glaucoma. Because intraocular pressure differences between DCT and GAT were independent of CCT, DCT and GAT are susceptible to similar measurement biases depending on CCT.

Author Affiliations: Department of Ophthalmology, University Hospital Basel, Basel, Switzerland.