A Comparative Study of the Handheld IC200 and Slit Lamp-mounted ST500 Rebound Tonometers with Goldmann Applanation Tonometry

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2025-03-01 DOI:10.1016/j.ogla.2024.10.008

Ryo Tomita MD, Glen P. Sharpe MSc, Devin Betsch MD, Rodolfo Bonatti MD, Balwantray C. Chauhan PhD

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Abstract

Objective

To compare the agreement and repeatability of intraocular pressure (IOP) measured with the slit lamp-mounted ST500 rebound tonometer (iCare Finland Oy), the hand-held IC200 rebound tonometer (iCare Finland Oy), and Goldmann applanation tonometry (GAT).

Design

Cross-sectional study.

Participants

Glaucoma patients and staff of the Eye Care Centre, Nova Scotia Health.

Methods

Intraocular pressure was measured twice each with the IC200, ST500, and GAT. Bland-Altman analysis was used to compare each pair of tonometers and whether the difference between tonometers depended on mean IOP. Intraclass correlation coefficients were also computed. Repeatability of the measurements with each tonometer was assessed by calculating the mean and variance of the difference between the first and second measurements. The relationship between IOP and central corneal thickness was also evaluated.

Main Outcome Measures

Agreement and repeatability of IOP measurements with the IC200, ST500, and GAT.

Results

One eye of 157 participants (64 men and 93 women) with a median (interquartile range) age and central corneal thickness of 62 (45–72) years and 553 (533–572) μm, respectively, were enrolled. Median IOP with the IC200, ST500, and GAT was 17.1 (14.3–21.0), 16.5 (14.0–20.8), and 17.0 (14.0–20.5) mmHg, respectively, while the range of IOP (measured with GAT) was 8.5 to 53.0 mmHg. Measurements with the 3 tonometers were not statistically different from each other, and in neither of the 3 paired comparisons was the difference in IOP between 2 tonometers dependent on mean IOP. The intraclass correlation coefficient values (0.97–0.98) showed excellent agreement between the tonometers. The variance of the difference between the first and second measurements of the ST500 was significantly lower than that of GAT (P = 0.04) and IC200 (P < 0.01). Intraclass correlation coefficients for intratonometer repeatability were also excellent (0.97–0.99).

Conclusions

The ST500 shows good agreement with GAT over a large range of IOP and significantly higher repeatability compared to the IC200 and GAT, suggesting it may be advantageous in clinical settings where topical anesthesia or skilled staff are unavailable.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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手持式 IC200 和装在裂隙灯上的 ST500 回弹式眼压计与戈德曼眼压计的比较研究。

目的比较使用裂隙灯安装式 ST500 回弹式眼压计（iCare Finland Oy，芬兰赫尔辛基）、手持式 IC200 回弹式眼压计（iCare Finland Oy）和戈德曼眼压计（Goldmann applanation tonometry，GAT）测量眼压的一致性和可重复性：设计：横断面研究：青光眼患者和加拿大哈利法克斯新斯科舍省卫生局眼科护理中心的工作人员：方法：使用 IC200、ST500 和 GAT 各测量两次眼压。使用 Bland-Altman 分析法比较每对眼压计以及眼压计之间的差异是否取决于平均眼压。还计算了类内相关系数。通过计算第一次和第二次测量之间差异的平均值和方差，评估了每种眼压计测量的重复性。还评估了眼压与中心角膜厚度之间的关系：用 IC200、ST500 和 GAT 测量眼压的一致性和重复性：结果：157 名参与者（64 名男性和 93 名女性）中有一只眼睛参加了测量，他们的中位（四分位间范围）年龄和角膜中央厚度分别为 62 (45 - 72) 岁和 553 (533 - 572) μm。使用 IC500、ST500 和 GAT 测量的中位眼压分别为 17.1（14.3 - 21.0）、16.5（14.0 - 20.8）和 17.0（14.0 - 20.5）毫米汞柱，而使用 GAT 测量的眼压范围为 8.5 - 53.0 毫米汞柱。三种眼压计的测量结果没有统计学差异，在三次配对比较中，两种眼压计之间的眼压差异都不取决于平均眼压。ICC 值（0.97-0.98）表明眼压计之间的一致性非常好。ST500 第一次和第二次测量之间的差异方差明显低于 GAT（P = 0.04）和 IC200（P < 0.01）。测试仪内部重复性的 ICC 也非常好（0.97-0.99）：ST500 在较大的眼压范围内与 GAT 有良好的一致性，重复性明显高于 IC200 和 GAT，这表明在没有局部麻醉或熟练工作人员的临床环境中，ST500 可能具有优势。

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