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Underestimation of intraocular pressure after photorefractive keratectomy: a biomechanical analysis
Department of Biomedical Engineering and Informatics, University Hospital, Umeå, Sweden.ORCID iD: 0000-0003-2055-576X
Department of Biomedical Engineering and Informatics, University Hospital, Umeå, Sweden.ORCID iD: 0000-0002-2031-722X
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Ophthalmology.
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2006 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 44, p. 609-618Article in journal (Refereed) Published
Abstract [en]

Excimer laser surgery, to correct corneal refraction, induces changes in corneal thickness and curvature. Both factors can cause measurement errors when determining intraocular pressure (IOP). This study evaluates effects of photorefractive keratectomy (PRK) on IOP measurements, using Goldmann applanation tonometry (GAT) and Applanation resonance tonometry (ART), in an in vitro model. Six porcine eyes was enucleated and pressurised to a constant IOP = 30 mmHg. After removal of the epithelium, the eyes were PRK-treated for a total of 25 dioptres. The measured IOP decreased 13.2 mmHg for GAT and 9.0 mmHg for ART. The total underestimation by GAT was larger than for ART, and a part of the ART underestimation (3.5 mmHg) was assigned to sensitivity to the change in corneal surface structure resulting from the removal of epithelium. The flat contact probe of GAT, as compared with the convex tip of ART, provided explanation for the difference in IOP measurement error after PRK.

Place, publisher, year, edition, pages
Springer, 2006. Vol. 44, p. 609-618
Keywords [en]
Refractive correction, Laser, Applanation resonance tonometry, Goldmann applanation tonometry, Glaucoma, Measurement error, Eye
National Category
Ophthalmology
Research subject
ophthalmology
Identifiers
URN: urn:nbn:se:umu:diva-5129DOI: 10.1007/s11517-006-0093-6ISI: 000241095000001PubMedID: 16937203Scopus ID: 2-s2.0-33746970299Local ID: 744OAI: oai:DiVA.org:umu-5129DiVA, id: diva2:144521
Note

Originally included in thesis in manuscript form, with title "Underestimation of intraocular pressure after photorefractive keratectomy - a biomechanical analysis". 

Available from: 2006-05-03 Created: 2006-05-03 Last updated: 2022-06-28Bibliographically approved
In thesis
1. Applanation Resonance Tonometry for Intraocular Pressure Measurement
Open this publication in new window or tab >>Applanation Resonance Tonometry for Intraocular Pressure Measurement
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucoma. Since glaucoma is a leading cause of blindness, reliable methods for measuring the IOP are important. This doctoral dissertation presents a new method, applanation resonance tonometry (ART), for measurement of IOP. The method is based on resonance sensor technology combined with the novel multipoint analysis of continuously sampled data of both contact force and contact area. The ART was evaluated in in vitro porcine-eye studies as well as in clinic on both healthy volunteers and patients.

A new symmetric probe with a larger sensor tip and improved aligning light was developed and evaluated in vitro. It showed that the error from off-centring was highly reduced. The new ART probe, used as a biomicroscope device (ARTBiom) and as a handheld device (ARTHand), was further evaluated in a clinical study designed in accordance with the International Standard Organisation’s (ISO) requirement. Both the ARTBiom and the ARTHand met the precision set by the requirements.

Laser surgery is a common way to correct vision. The biomechanical effect of photorefractive keratectomy (PRK) on IOP measurements was evaluated using Goldmann applanation tonometry (GAT) and ART in an in vitro study. Both methods were affected, but to a different extent. The flat contact probe of GAT, as compared with the convex tip of ART, and single point vs. multipoint approach, provide explanation to the ART advantage regarding measurement error of IOP after PRK.

In conclusion, resonance sensor technology has made it possible to introduce a new multipoint method for measuring IOP, and the method is relevant for measuring IOP in humans. It may be possible to reduce errors in the clinical measurement of IOP with this new method, especially after corneal surgery. The ART has the potential to become a useful clinical instrument for IOP measurement.

Place, publisher, year, edition, pages
Umeå: Tillämpad fysik och elektronik, 2006. p. 63
Series
Resonance Sensor Lab, ISSN 1653-6789 ; 1
Keywords
Physics, Resonance, applanation, tonometry, glaucoma, Goldmann, biomechanical, Intraocular, ART, Fysik
Research subject
Physics
Identifiers
urn:nbn:se:umu:diva-784 (URN)91-7264-061-8 (ISBN)
Public defence
2006-05-24, Sal B, 9tr., Tandläkarhögskolan, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2006-05-03 Created: 2006-05-03 Last updated: 2010-02-01Bibliographically approved

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Hallberg, PerEklund, AndersLindahl, Olof A.Lindén, Christina

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