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Publications (3)2.8 Total impact

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    ABSTRACT: We performed a comparative study using Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT) to measure intraocular pressure (IOP) in eyes with keratoconus. IOP was measured in 114 eyes of 75 patients with keratoconus (51 men and 24 women; mean age, 36.1 ± 11.2 years) using GAT and DCT in randomized order. Central corneal thickness (CCT), minimal corneal thickness (MCT), and corneal topography were recorded using the Pentacam. Four groups according to Amsler's keratoconus classification were composed and analyzed for significant differences of CCT, MCT, GAT, and DCT results. Mean CCT in the 114 keratoconus eyes was 481.1 ± 46.2 μm (range, 334-601 μm). Mean MCT was 453.3 ± 56.3 μm (range, 239-573 μm). Mean IOP measured using GAT was 13.1 ± 2.9 mm Hg, whereas mean IOP measured using DCT was 14.8 ± 2.6 mm Hg. Neither the results for GAT nor those for DCT showed a significant correlation with CCT (Pearson correlation: P < 0.05). Multifactorial analysis revealed that CCT and MCT, but not GAT and DCT, results were significantly different in corneas of varying curvatures. This study shows that DCT measures IOP higher than GAT in eyes with keratoconus. In keratoconus, both methods seem to be independent of CCT and therefore are equally, but not interchangeably, applicable when monitoring IOP. Further analysis revealed that CCT and MCT are significantly different in corneas of varying Amsler grade.
    Cornea 06/2011; 30(10):1078-82. · 1.75 Impact Factor
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    ABSTRACT: ZielGoldstandard in der Diagnostik des intraokularen Drucks (IOD) ist bislang die Goldmann-Applanationstonometrie (GAT), die jedoch abhängig von Hornhautdicke und -kurvatur ist. Bei Patienten mit Keratokonus, die eine anormale Hornhautgeometrie und -dicke aufweisen, ist die Druckmessung mittels GAT oft schwierig und wenig reproduzierbar. Ziel unserer Untersuchung war es, die dynamische Konturtonometrie (DCT), ein digitales Verfahren, das an die normale Hornhautgeometrie angepasst ist, mit der GAT im Hinblick auf ihre Abhängigkeit von der zentralen Hornhautdicke (CCT) bei Keratokonus zu vergleichen. MethodenDer IOD wurde bei 54Patienten (38 Männer und 16 Frauen, mittleres Alter 36±9,9Jahre) in randomisierter Reihenfolge mit dem GAT und dem DCT erhoben. Alle Patienten hatten einen topographisch gesicherten Keratokonus. Zusätzlich wurde die zentrale Hornhautdicke mittels Pentacam bestimmt. Zur statistischen Auswertung wurde die Pearson-Korrelation berechnet und ein Bland-Altman-Diagramm erstellt. ErgebnisseDie mittlere zentrale Hornhautdicke betrug 486,2±45,5μm. Bei Verwendung der DCT betrug der IOD im Mittel 14,9±2,6mmHg und bei der GAT 13,3±2,9mmHg. Damit lag die DCT mit im Mittel 1,6±2,4mmHg signifikant höher (p≤0,05). Sowohl die Messungen des IOD mit GAT (r=−0,03; p>0,05) als auch die Messwerte mit DCT (r=0,08; p>0,05) zeigten keine signifikante Abhängigkeit von der CCT. SchlussfolgerungenAm Beispiel des Keratokonus bestätigt sich, dass die mittels GAT gemessenen IOD-Werte niedriger sind als bei Verwendung der DCT. Da beide Verfahren unabhängig von der Hornhautdicke messen, eignen sie sich gleichermaßen zur Verlaufskontrolle des intraokularen Drucks bei Augen mit Keratokonus, bei denen es zu einer progredienten Hornhautverdünnung kommen kann. PurposeThe gold standard for measuring intraocular pressure (IOP) until now has been Goldmann applanation tonometry (GAT), which depends on the central corneal thickness (CCT) and curvature. In patients with keratoconus who have an abnormal corneal geometry and thickness, measurement of pressure with GAT is often difficult and not very reproducible. We compared the impact of the central corneal thickness (CCT) on the IOP measured with dynamic contour tonometry (DCT), a digital method which is adapted to the corneal geometry, and GAT in patients with keratoconus. MethodsIOP was measured in 54 patients (38 men and 16 women, mean age of 36±9.9years) with GAT and DCT in randomized order. All patients had a keratoconus which was assured by topography. In addition central corneal thickness (CCT) was measured with the Pentacam. For statistical analysis the Pearson correlation was calculated and a Bland-Altman diagram plotted. ResultsMean corneal thickness was 486.2±45.5μm. DCT measured the IOP at a mean value of 14.9±2.6mmHg and GAT at 13.3±2.9mmHg. With a mean difference of 1.6±2.4mmHg DCT measured significantly higher than GAT (p≤0.05) Neither IOP measurements with GAT (r=−0.03; p>0.05) nor those with DCT (r=0.08; p>0.05) showed a significant correlation to central corneal thickness. ConclusionThe example of keratoconus confirms that IOP measured by GAT is lower than if measured by DCT. Because both methods are independent of the CCT they are equally acceptable for IOP follow-up in eyes with keratoconus, which may result in progressive corneal thinning in the long term.
    Der Ophthalmologe 01/2009; 106(6):531-535. · 0.53 Impact Factor
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    ABSTRACT: The gold standard for measuring intraocular pressure (IOP) until now has been Goldmann applanation tonometry (GAT), which depends on the central corneal thickness (CCT) and curvature. In patients with keratoconus who have an abnormal corneal geometry and thickness, measurement of pressure with GAT is often difficult and not very reproducible. We compared the impact of the central corneal thickness (CCT) on the IOP measured with dynamic contour tonometry (DCT), a digital method which is adapted to the corneal geometry, and GAT in patients with keratoconus. IOP was measured in 54 patients (38 men and 16 women, mean age of 36+/-9.9 years) with GAT and DCT in randomized order. All patients had a keratoconus which was assured by topography. In addition central corneal thickness (CCT) was measured with the Pentacam. For statistical analysis the Pearson correlation was calculated and a Bland-Altman diagram plotted. Mean corneal thickness was 486.2+/-45.5 microm. DCT measured the IOP at a mean value of 14.9+/-2.6 mmHg and GAT at 13.3+/-2.9 mmHg. With a mean difference of 1.6+/-2.4 mmHg DCT measured significantly higher than GAT (p<or=0.05) Neither IOP measurements with GAT (r=-0.03; p>0.05) nor those with DCT (r=0.08; p>0.05) showed a significant correlation to central corneal thickness. The example of keratoconus confirms that IOP measured by GAT is lower than if measured by DCT. Because both methods are independent of the CCT they are equally acceptable for IOP follow-up in eyes with keratoconus, which may result in progressive corneal thinning in the long term.
    Der Ophthalmologe 08/2008; 106(6):531-5. · 0.53 Impact Factor