Comparison of dynamic contour tonometry and goldmann applanation tonometry in glaucoma patients and healthy subjects

Am J Ophthalmol. 2006 Oct;142(4):583-90. doi: 10.1016/j.ajo.2006.05.030.


Purpose: To investigate the agreement in the measurement of intraocular pressure (IOP) obtained by dynamic contour tonometry PASCAL (DCT-PASCAL) and Goldmann applanation tonometry (GAT) in glaucoma eyes and healthy eyes with different central corneal thickness (CCT).

Design: Prospective cross-sectional study.

Methods: In a randomized order, three consecutive IOP measurements were performed on 197 eyes of 107 subjects by one examiner using both DCT-PASCAL and GAT on all eyes. Furthermore, ultrasonic pachymetry was performed. The Spearman correlation coefficient (r) was determined to compare IOP readings between DCT-PASCAL and GAT. Regression-based Bland and Altman analysis was used to evaluate agreement between the instruments.

Results: Mean IOP values obtained by both instruments were significantly correlated in healthy and glaucoma eyes (all healthy eyes [n = 66]: r = 0.8, P < .001, all glaucoma eyes [n = 131]: r = 0.96, P < .001). Neither GAT nor DCT-PASCAL showed a significant correlation with CCT (GAT: all eyes: r = 0.009, P = .9, DCT-PASCAL: all eyes: r = -0.05, P = .5). Bland and Altman analysis revealed the existence of proportional bias. Thus, 95% limits of agreement between the instruments varied with the actual IOP measurement.

Conclusions: DCT-PASCAL and GAT revealed a strong correlation in IOP measurements between glaucoma and healthy eyes. However, the analysis of agreement indicated some discrepancies between the instruments. Measurements with both GAT and DCT-PASCAL were not correlated with central corneal thickness.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cornea / diagnostic imaging
  • Cross-Sectional Studies
  • Female
  • Glaucoma / diagnosis*
  • Humans
  • Intraocular Pressure*
  • Male
  • Middle Aged
  • Ocular Hypertension / diagnosis
  • Prospective Studies
  • Reproducibility of Results
  • Tonometry, Ocular / methods*
  • Ultrasonography
  • Visual Acuity
  • Visual Field Tests