Misleading Goldmann applanation tonometry in a post-LASIK eye with interface fluid syndrome

Senthil, Sirisha; Rathi, Varsha; Garudadri, Chandrasekhar
June 2010
Indian Journal of Ophthalmology;Jun2010, Vol. 58 Issue 4, p333
Academic Journal
Case Study
A 21-year-old myope presented with decreased vision and corneal edema following vitreoretinal surgery for retinal detachment. While intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT) was low, the digital tonometry indicated raised pressures. An interface fluid syndrome (IFS) was suspected and confirmed by clinical exam and optical coherence tomography. A tonopen used to measure IOP through the peripheral cornea revealed elevated IOP which was the cause of the interface fluid. Treatment with IOP-lowering agents resulted in complete resolution of the interface fluid. This case is being reported to highlight the fact that IFS should be suspected when there is LASIK flap edema and IOP readings using GAT are low and that GAT is not an optimal method to measure IOP in this condition. Alternative methods like tonopen or Schiotz tonometry can be used.


Related Articles

  • New instrumentation offers advance for IOP measurement. Guttman, Cheryl; Pepose, Jay // Ophthalmology Times;3/1/2006, Vol. 31 Issue 5, p51 

    The article describes the benefits and applications of tonometry technology compared with the existing Goldmann tonometry for more accurate intraocular pressure measurement in post-LASIK eyes. Several instruments include Goldmann applanation tonometry, the Pascal Dynamic Contour Tonometer SMT...

  • A Glaucoma Case with Masked Increasing Intraocular Pressure due to Flep Interface Fluid Accumulation After Refractive Surgery. Artunay, Özgür; Rasier, Rifat; Şengül, Alper; Yüzbağioğlu, Erdal; Bahçecioğlu, Halil // Glokom-Katarakt/Journal of Glaucoma-Cataract;Jun2010, Vol. 5 Issue 2, p114 

    In this study we describe a case with interface fluid syndrome developing after laser in situ keratomileusis (LASIK) result from steroid-induced intraocular pressure (IOP) elevation.The aim of this study was to emphasize the importance of ocular manifestations and clinical course of interface...

  • Intraocular Pressure Measurement After Hyperopic and Myopic LASIK. Jarade, Elias F.; Abi Nader, FranÇoise C.; Tabbara, Khaled F. // Journal of Refractive Surgery;Jul2005, Vol. 21 Issue 4, p408 

    PURPOSE: To assess the effects of hyperopic and myopic laser in situ keratomileusis (LASIK) on the intraocular pressure (IOP) measurement by Goldmann applanation tonometry. METHODS: Intraocular pressure was measured by Goldmann applanation tonometry pre- and postoperatively in 48 hyperopic eyes...

  • Retinal Nerve Fiber Layer Changes After LASIK Evaluated With Optical Coherence Tomography. Dementyev, Dmitriy D.; Kourenkov, Vyacheslav V.; Rodin, Alexander S.; Fadeykina, Tatyana L.; Diaz Martines, Tatyana E. // Journal of Refractive Surgery;Sep2005 Supplement, pS623 

    PURPOSE: To determine whether the increase in intraocular pressure (IOP) during LASIK suction can induce a decrease in retinal nerve fiber layer thickness assessed by optical coherence tomography (OCT). METHODS: Nineteen patients (38 eyes) were enrolled in the study. Intraocular pressure was...

  • Intraocular pressure variability in patients who reached target intraocular pressure. Malerbi, F. K.; Halonaka, M.; Vessani, R. M.; Susanna, Jr., R. // British Journal of Ophthalmology;May2005, Vol. 89 Issue 5, p540 

    Aim: To assess the intraocular pressure (lOP) variability in patients with primary open angle glaucoma (POAG) under clinical treatment who reached an established target pressure based on isolated office readings. Methods: Retrospective analysis of 65 eyes from 65 POAG patients under clinical...

  • How to measure intraocular pressure: applanation tonometry. Stevens, Sue; Gilbert, Clare; Astbury, Nick // Community Eye Health Journal;2012, Vol. 25 Issue 79/80, p60 

    The article offers instructions for measuring intraocular pressure (IOP) using Goldmann tonometer. It cites the applanation tonometry preparation and the equipment used measuring IOP including applanation prism, fluorescein strips, and local anaesthetic drops. It also offers the methods in...

  • tonography.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p2334 

    A definition of the medical term "tonography," which refers to the recording of changes in intraocular pressure is presented.

  • Getting a Better Read on Tonometry. Murphy, Rob // Review of Optometry;05/15/2000, Vol. 137 Issue 4, p49 

    Focuses on the importance of tonometry in the evaluation of glaucoma in the United States. Estimation of intraocular pressures through Goldmann tonometry; Significance of the corneal thickness and elasticity on the reliability of Goldmann; Importance of serial tonometry in identifying the peak...

  • Alternative tonometers may be considered for measuring IOP in children.  // Ocular Surgery News;10/10/2011, Vol. 29 Issue 19, p24 

    The article discusses a research study which suggests that there are alternatives to Goldmann tonometry for measuring intraocular pressure in children.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics