Applanation Resonance Tonometry for Intraocular Pressure Measurement

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