Messverfahren der Tonometrie

 

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Zusammenfassung

Die korrekte Interpretation tonometrischer Messwerte in der Augenheilkunde ist in den letzten Jahren immer komplexer geworden. Große klinische Untersuchungen hatten zunächst gezeigt, dass in der Bevölkerung die mittlere zentrale Hornhautdicke bei 550 µm anzunehmen ist. Da jedoch die valide Applanationstonometrie von Goldmann auf eine zentrale HH-Dicke von 520 µm ausgelegt ist, werden mathematische Korrekturformeln zur Berechnung des angenommenen wahren Augeninnendrucks diskutiert. Neuere Tonometrieverfahren, wie z. B. die dynamische Konturtonometrie, wurden entwickelt, um das physikalische Problem der Hornhautdicke zu umgehen. Das zusätzliche Inbetrachtziehen viskoelastischer Eigenschaften der Hornhaut, wie dies mit der kornealen Hysterese und dem kornealen Resistenzfaktor bei der Tonometrie mit dem Ocular Response Analyzer in die Messung miteinbezogen wird, unterstreicht die Komplexizität der modernen Tonometrie. Ziel dieses Beitrags ist es, die derzeit gebräuchlichen Messverfahren vorzustellen und in ihrer klinischen Bedeutung einzuordnen.

Abstract

The correct interpretation of measured tonometric values has become more and more complex in recent years. Large clinical studies have shown that an average central corneal thickness (CCT) of 550 µm can be assumed for the general population. Since the standard Glodmann applanation tonometry is based on a central corneal thickness of 520 µm, mathematical correction formula have been discussed for calculation of the true intraocular pressure. Newer tonometry devices, e. g. the dynamic contour tonometry (DCT) which seems to be independent from CCT, or the Ocular Response Analyzer® (ORA), taking into account the biomechanical properties of the cornea, have been designed to measure intraocular pressure (IOP). In this article, several IOP measurement devices and their clinical relevance for a correct and feasible determination of the IOP are discussed.

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Dr. Matthias Neuburger

Augenklinik, Universitätsklinik Freiburg

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79106 Freiburg

Phone: ++ 49/7 61/2 70 40 01

Fax: ++ 49/7 61/2 70 41 27

Email: matthias.neuburger@uniklinik-freiburg.de