Agreement and reproducibility of Tono-Pen XL tip covered with ocufilm and fingertip of surgical glove in intra-ocular pressure measurement.
OBJECTIVE
To compare the effect of using the fingertip of a surgical glove over Ocufilm (Reichert Technologies, NY, USA) on the agreement and reproducibility of measuring intra-ocular pressure (IOP) by the Tono-Pen XL (Reichert Technologies, NY USA).


METHODS
Experimental, clinical study.


METHODS
Patients were randomized into two groups to receive IOP measurements using Tono-Pen XL with two different types of tip covers. In Group 1, the IOP of the right eyes were first measured using Ocufilm as the tip cover followed by using the fingertip of a surgical glove. As for the left eyes, the tip of the surgical glove was used first, followed by use of Ocufilm. In Group 2, the IOP of the right eyes was first measured using the tip of the surgical glove,followed by use of Ocufilm, while for the left eye the latter was used first, followed by the tip of the surgical glove. A single operator measured the IOP in each eye twice using each type of tip cover. Agreement between the Tono-Pen XL measurements using the two different tip covers was analyzed using the Bland-Altman analysis. The difference between the repeated measures was assessed for reproducibility of the Tono-Pen XL measurements with regard to each type of tip covers.


RESULTS
100 patients (200 eyes) were recruited into the present study. The mean difference of IOP taken by the Tono-Pen XL covered with Ocufilm and the fingertip of a surgical glove was -0.21 mmHg (95% CI: -0.36 to -0.05). The limits of agreement (confidence interval 95%) as calculated by the Bland-Altman plots for Ocufilm-Fingertip of a surgical glove was -2.43 to +2.02 mmHg. The coefficient of repeatability of the Ocufilm vs. the surgical glove was nearly the same (1.74 vs. 2.37, respectively).


CONCLUSIONS
A significant agreement exists between using Ocufilm and the fingertip of a surgical glove to cover the tip of a Tono-Pen XL for measuring IOP The coefficient of repeatability was comparable between the two different types of tip covers. When measuring IOP the tip of a Tono-Pen XL could therefore be covered by either Ocufilm or the fingertip of a surgical glove without compromising accuracy.
Department of Ophthalmology, Khon Kaen University, Khon Kaen, Thailand. niphons@gmail.com
Niphon
N
Sayawat
Duangdao
D
Duangnumsawang
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D005932:Gloves, Surgical; D006801:Humans; D007429:Intraocular Pressure; D007840:Latex; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014065:Tonometry, Ocular / Q000295:instrumentation*; D055815:Young Adult
D007840:Latex