title: Rebound tonometry versus Goldmann tonometry in school children: feasibility and agreement of intraocular pressure measurements.
abstract: OBJECTIVE
  High intraocular pressure (IOP) is an important risk factor for a variety of pediatric ophthalmic conditions. The purpose of this study is to evaluate the feasibility, length of examination, and corneal epithelial damage induced by rebound tonometry (RBT) versus Goldmann applanation tonometry (GAT) in school children.
  
  
  METHODS
  Healthy children (n=57) participated in a randomized, transversal study with IOP measurement by GAT followed by RBT (study arm 1) or RBT followed by GAT (study arm 2). The number of attempts to acquire a reliable IOP measurement and the length of the examination were quantified. Corneal epithelial damage induced by tonometry was evaluated. Bland-Altman analysis was performed to establish the level of agreement between the two techniques.
  
  
  RESULTS
  The IOP was measured in all children with at least one of the devices. In both study arms, more children failed to be examined with GAT than with RBT (26% vs. 4%, and 16% vs. 6%, p<0.001, in study arm 1 and 2, respectively). The length of examination was shorter for RBT than for GAT (67.81 s ± 35.20 s vs. 126.70 s ± 56.60 s; p<0.0001); IOP measurements with RBT in both study arms were higher than those with GAT (15.20 ± 2.74 mmHg vs. 13.25 ± 2.47 mmHg, p=0.0247 and 16.76 ± 3.99 mmHg vs. 13.92 ± 2.08 mmHg, p=0.003, respectively). No difference was observed between RBT and GAT regarding the corneal epithelial damage caused by tonometry.
  
  
  CONCLUSIONS
  IOP measurement is feasible in a greater number of children with RBT, and the examination was faster than that for GAT. Compared with GAT, RBT tended to overestimate the IOP. None of the methods induced marked corneal epithelial defects.
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Bruno Leonardo Barranco
authors.initials: BL
authors.lastname: Esporcatte
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Flávio Siqueira Santos
authors.initials: FS
authors.lastname: Lopes
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Fonseca Netto
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Vespasiano
authors.initials: V
authors.lastname: Rebouças-Santos
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Diego Torres
authors.initials: DT
authors.lastname: Dias
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fábio Iglesias
authors.initials: FI
authors.lastname: Marujo
authors.affiliation: Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Christiane
authors.initials: C
authors.lastname: Rolim-de-Moura
mesh_terms: D002648:Child; D003315:Cornea / Q000033:anatomy & histology*; D065306:Corneal Injuries / Q000209:etiology; D063171:Corneal Pachymetry / Q000379:methods; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D012016:Reference Values; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013997:Time Factors; D014065:Tonometry, Ocular / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*