Varying effects of corneal thickness on intraocular pressure measurements with different tonometers

Aims: To compare the intraocular pressure (IOP) measurements using the Goldmann applanation tonometer (GAT), noncontact tonometer (NCT), and ocular blood flow tonometer (OBFT), and to evaluate the effects of varying central corneal thickness (CCT) on the readings. Methods: Ultrasound pachymetry and tonometry were performed on 170 eyes. Using the corrected GAT values that took CCT into account as the standard, we calculated the NCT and OBFT measurement errors related to the CCT variable by a linear regression model. Group comparisons were performed with the χ² test and one-way ANOVA test. The correlation between the various tonometer measurements was analysed by Pearson's correlation method. Results: Both the NCT (r=0.872, P<0.001) and OBFT measurements (r = 0.861, P < 0.001) were highly correlated with the GAT measurements. IOP measurements using the three tonometers were all correlated with CCT (all P < 0.001), with the NCT measurements showing the greatest regression coefficient (β = 0.063, r = 0.650) and the GAT measurements the least (β = 0.037, r = 0.496). A linear regression model indicated that a 10 μm change in CCT resulted in a NCT measurement deviation of 0.47-0.98 mmHg and an OBFT measurement deviation of 0.29-0.81 mmHg. Conclusion: Pressure readings with the GAT, NCT, and OBFT are all affected by CCT, with the NCT being the one most affected and the GAT the least. Our findings suggest CCT an essential variable to consider in interpreting IOP readings, especially for the NCT measurements.