Comparison of dynamic contour tonometry with Goldman applanation tonometry over a wide range of central corneal thickness

Purpose: To compare dynamic contour tonometry with Goldmann applanation tonometry in structurally normal corneas over a wide range of central corneal thickness (CCT). Patients and Methods: Twenty-five patients each with normal CCT (group A), thin corneas (group B), and thick corneas (group C) had IOP measured with the Goldmann (GAT) and dynamic contour tonometer (DCT). Results: In group A (mean CCT = 5 52 +/- 16 mu m) the mean GAT was 15.9 +/- 3.1 mm Hg and mean DCT was 16 +/- 3.3 mm Hg (P = 0.91). In group B (mean CCT = 491 +/- 19 mu m) the mean GAT was 13.2 +/- 3.5 mm Hg and the mean DCT was 15.9 +/- 3.5 mm Hg (P = 0.009). For group C (mean CCT = 615 +/- 22 mu m), the mean GAT was 17.4 +/- 3.8 mm Hg and the mean DCT was 17.4 +/- 3.5 mm Hg (P = 0.95). The 95% agreement limits for DCT were -3.1 mm Hg to 2.9 mm Hg. The mean GAT-DCT difference was -2.6 mm Hg in thin corneas and -0.06 mm Hg in thick corneas. Below 520 mu m reduction of 10 mu m in CCT appears to result in a significant underestimation of the GAT IOP by 0.7 mm Hg (P < .001) and above 580 mu m a nonsignificant overestimation of 0.2 mm Hg per 10 mu m increase in CCT (P = 0.27). Conclusion: Dynamic contour tonometer agrees well on average with GAT but the agreement limits are wide. In structurally normal thin corneas DCT may give a more accurate assessment of the true IOP but it does not appear to have any benefit over GAT in thick corneas.