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

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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.

About the authors

Sergey Y. Petrov

Helmholtz National Medical Research Center of Eye Diseases

Email: glaucomatosis@gmail.com
ORCID iD: 0000-0001-6922-0464

Dr. Sci. (Med.), Professor, head of the Department of glaucoma

Russian Federation, Moscow

Olga M. Filippova

Helmholtz National Medical Research Center of Eye Diseases

Author for correspondence.
Email: changa2@mail.ru
ORCID iD: 0000-0001-9082-4537

Cand. Sci. (Med.), research associate of the Department of glaucoma

Russian Federation, Moscow

Oksana I. Markelova

Helmholtz National Medical Research Center of Eye Diseases

Email: Levinaoi@mail.ru
ORCID iD: 0000-0002-8090-6034

postgraduate student of the Department of glaucoma

Russian Federation, Moscow

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Supplementary files

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1. JATS XML
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2. Fig. 1. Transpalpebral tonometer TVGD-02 (Yelatma instrument-making enterprise joint-stock company, Russia)

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3. Fig. 2. Pathological changes of the cornea in patients

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4. Fig. 3. Variants for changing the configuration of the corneal surface

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5. Fig. 4. Cornea deformation after penetrating keratoplasty

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6. Fig. 5. Intraocular pressure indicators obtained by measuring by various methods. TPT — transpalpebral tonometry; PP — palpation technique; ricochet — ricochet tonometry; Maklakov — tonometry according to Maklakov

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