Intraocular pressure in keratoconus.

PURPOSE: This study aimed to investigate intraocular pressure (IOP) measurements taken using the dynamic contour tonometer (DCT) and the non-contact tonometer (NCT) in subjects with keratoconus.

METHODS

Intraocular pressure was measured in 20 keratoconus subjects and 20 age-matched control subjects using the DCT and NCT instruments. Central and off-centre measures were taken with the DCT in order to highlight any systematic errors associated with corneal biomechanical factors. Measures of anterior and posterior corneal topography and thickness were also taken in each subject.

RESULTS

No significant difference was found between the central and off-centre DCT IOP readings for the keratoconus subjects and age-matched controls (p > 0.05). The average DCT IOP was 14.2 ± 1.4 mmHg in the keratoconus subjects and 14.2 ± 1.6 mmHg in the controls. However, the average NCT readings differed significantly (p < 0.001) between the keratoconus subjects (9.2 ± 1.5 mmHg) and the controls (12.9 ± 2.4 mmHg). Intraocular pressure measurements taken with the DCT showed no significant (p > 0.05) correlation with the severity of keratoconus as determined through measures of corneal topography and thickness. Equivalent IOP measurements taken with the NCT correlated significantly with certain measures of corneal curvature and thickness in the keratoconus population. The difference between DCT and NCT IOP was strongly correlated with measures of corneal topography and thickness, with differences increasing in more advanced keratoconus.

CONCLUSIONS

The measurements obtained with the DCT do not appear to be dependent upon corneal factors, unlike those taken with the NCT. The presence or severity of keratoconus was not correlated with DCT IOP values.