Is Icare as Accurate as Goldmann or Perkins Applanation Tonometry at Measuring Intraocular Pressure in the Setting of Suspected or Diagnosed Congenital Glaucoma?: A Systematic Review

Jaimee Barclay BAppSc MOrth

Amanda Moore BAppSc MOrth

Discipline of Orthoptics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
 

ABSTRACT

Background: The present study aims to analyse the accuracy of iCare rebound tonometers, compared to the gold standard Goldmann or Perkins applanation tonometry in congenital glaucoma patients and suspects.

Methods: Two individual researchers were tasked with individually searching five different databases, including Medline, Embase, CINHAL, Cochrane and Elsevier/Scopus, using preidentified keywords and terms. Following this, each researcher then screened the results to rule out any that did not meet strict selection criteria or were outside the scope of the present study. Selection criteria pertained to age of participants, tonometry tools used and whether participants were either congenital glaucoma suspects or patients already diagnosed with congenital glaucoma and being monitored. The two researchers than reconvened to discuss individual results and mitigate any discrepancies in results. All studies were then assessed via the Critical Appraisal Skills Programme Checklist (CASP) and QUADAS-2 tools for risk of bias. Following this, five studies were included in the reports analysis.

Results: Within the five included studies, there were a total of 580 eyes, all of which were affected by a form of congenital glaucoma. There were no limitations on the type of glaucoma included, whether that be primary, secondary or normal tension glaucoma, and all participants were below 18 years of age. Overall results showed a positive consistency and accuracy between the two devices, but arguments were made against the tools interchangeability. Additionally, the results presented in some studies were recommended within select parameters for which these results can be applicable.

Conclusion: In avast majority of cases, iCare or rebound tonometry can be interchanged with Goldmann applanation tonometry to ease the measurement of intraocular pressure in a paediatric setting. This suggests that in most clinical cases clinicians should be able to utilise iCare for ease of measurement without risk of over or underestimating intraocular pressure.