Repeatability and Reproducibility of Goldmann Applanation, Dynamic Contour, and Ocular Response Analyzer Tonometry

Purpose: To evaluate the repeatability and interoperator reproducibility of the Pascal dynamic contour tonometry (DCT), ocular response analyzer (ORA), and Goldmann applanation tonometer (GAT) in a single population of normal individuals. Methods: The study included 52 eyes from 26 normal individuals. One operator measured the intraocular pressure (IOP) with each tonometer 3 times while 2 additional operators each measured the IOP with each tonometer once. Repeatability and reproducibility were assessed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). Agreement among tonometers was also assessed using Bland-Altman plots. Results: The mean age of included participants was 31.5 +/- 8.8 years and 15 (58%) were female individuals. In general, both intra-operator repeatability and interoperator reproducibility were significantly higher for DCT compared with the other tonometers. Intraoperator DCT (CV = 3.7, ICC = 0.89), GAT (CV = 9.7, ICC = 0.79), IOPg (CV = 7.0, ICC = 0.79), and IOPcc (CV = 9.8, ICC = 0.57). Interoperator DCT (CV = 6.1, ICC = 0.73), GAT (CV = 9.0, ICC = 0.82), and IOPg (CV = 10.8, ICC = 0.63), IOPcc (CV = 11.7, ICC = 0.49). Conclusion: Overall, DCT was significantly more repeatable and reproducible than GAT, IOPg and IOPcc. The better reproducibility of the DCT may result in more precise measurements for monitoring IOP changes over time compared to GAT and ORA.