Tonometry after laser in situ keratomileusis treatment.
OBJECTIVE
To assess the reliability of intraocular pressure measurements by Goldmann applanation tonometry versus pneumotonometry after laser in situ keratomileusis for myopia.


METHODS
In this prospective study, corneal Goldmann applanation tonometry and pneumotonometry measurements were made in 118 eyes of 60 patients before and 1 and 3 months after undergoing laser in situ keratomileusis for myopia. Manifest refraction, ultrasonic corneal thickness measurements, and keratometry readings were also obtained.


RESULTS
Preoperative intraocular pressure showed a good correlation between Goldmann applanation tonometry and pneumotonometry values (Pearson r = 0.71; P < 0.001). although Goldmann applanation tonometry readings were slightly higher at low intraocular pressure values and slightly lower at high intraocular pressure values. After a mean stromal ablation depth of 77.1 microm, mean intraocular pressure by Goldmann applanation tonometry decreased significantly (P < 0.001) from a preoperative value of 14.8 +/- 11.9 mm Hg to 11.9 +/- 2.1 mm Hg and 11.7 +/- 1.7 mm Hg after 1 and 3 months, respectively. Mean pre- and post-laser in situ keratomileusis measurements by pneumotonometry were similar (P = 0.8). Differences of postoperative intraocular pressure measurements by Goldmann applanation tonometry and pneumotonometry were statistically significant. After 3 months, there was a poor correlation between Goldmann applanation tonometry and pneumotonometry intraocular pressure values (Pearson r = 0.58). Postoperative intraocular pressure decrease in applanation tonometry correlated with changes in keratometry, spherical equivalent, and central corneal thickness. Regression analysis showed a decrease of 2.9 mm Hg per 70 microm reduction in central corneal thickness.


CONCLUSIONS
Contact pneumotonometry measures the IOP reliably after laser in situ keratomileusis for myopia, whereas Goldmann applanation tonometry underestimates the intraocular pressure. This may be important in the treatment of any future glaucoma.
Duch
S
S
Department of Ophthalmology, Ciutat Sanitària i Universitaria de Bellvitge, Barcelona, Spain.
Serra
A
A
Castanera
J
J
Abos
R
R
Quintana
M
M
D000328:Adult; D003315:Cornea / Q000601:surgery; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D011184:Postoperative Period; D011446:Prospective Studies; D015203:Reproducibility of Results; D014065:Tonometry, Ocular / Q000592:standards*