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    Goldmann Tonometer Prism with an Optimized Error Correcting Applanation Surface

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    Author
    McCafferty, Sean
    Lim, Garrett
    Duncan, William
    Enikov, Eniko
    Schwiegerling, Jim
    Affiliation
    Univ Arizona, Dept Ophthalmol
    Univ Arizona, Coll Opt Sci
    Univ Arizona, Coll Engn, Dept Mech & Aerosp
    Issue Date
    2016-09-09
    Keywords
    glaucoma
    intraocular pressure
    corneal biomechanics
    tonometry
    
    Metadata
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    Publisher
    ASSOC RESEARCH VISION OPHTHALMOLOGY INC
    Citation
    Goldmann Tonometer Prism with an Optimized Error Correcting Applanation Surface 2016, 5 (5):4 Translational Vision Science & Technology
    Journal
    Translational Vision Science & Technology
    Rights
    This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Purpose: We evaluate solutions for an applanating surface modification to the Goldmann tonometer prism, which substantially negates the errors due to patient variability in biomechanics. Methods: A modified Goldmann or correcting applanation tonometry surface (CATS) prism is presented which was optimized to minimize the intraocular pressure (lOP) error due to corneal thickness, stiffness, curvature, and tear film. Mathematical modeling with finite element analysis (FEA) and manometric lOP referenced cadaver eyes were used to optimize and validate the design. Results: Mathematical modeling of the optimized CATS prism indicates an approximate 50% reduction in each of the corneal biomechanical and tear film errors. Manometric lOP referenced pressure in cadaveric eyes demonstrates substantial equivalence to GAT in nominal eyes with the CATS prism as predicted by modeling theory. Conclusion: A CATS modified Goldmann prism is theoretically able to significantly improve the accuracy of lOP measurement without changing Goldmann measurement technique or interpretation. Clinical validation is needed but the analysis indicates a reduction in CCT error alone to less than +/- 2 mm Hg using the CATS prism in 100% of a standard population compared to only 54% less than +/- 2 mm Hg error with the present Goldmann prism. Translational Relevance: This article presents an easily adopted novel approach and critical design parameters to improve the accuracy of a Goldmann applanating tonometer.
    ISSN
    2164-2591
    DOI
    10.1167/tvst.5.5.4
    Version
    Final published version
    Sponsors
    NIH SBIR [R43 EY026821-01]; Arizona Eye Consultants, Tucson
    Additional Links
    http://tvst.arvojournals.org/article.aspx?doi=10.1167/tvst.5.5.4
    ae974a485f413a2113503eed53cd6c53
    10.1167/tvst.5.5.4
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