The Influence Of Corneal Transplants On Intraocular Pressure Measurements Using Icare Home Tonometer
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR295 | Type: Free paper | DOI: 10.82333/wa3z-zm47
Authors: A/Prof. Adi Einan-Lifshitz* 1 , Dr Malachy יעקו Nemet 2 , Dr Anat Maytal 1 , Dr Biana Dubinsky-Pertzov 1 , Dr Noa Cohen Sinai 3 , Dr Shir Cohen 1
1Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel.,Tzrifin,Israel, 2School of Medicine, The Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.,Tel Aviv,Israel, 3Department of Ophthalmology, Bnai Zion Medical Center, Haifa, Israel.,Haifa,Israel
Purpose
To evaluate the agreement between Goldmann Applanation Tonometry (GAT) and the Icare Home (ICH) rebound tonometer in eyes that have undergone different types of corneal transplantation and to identify clinical factors associated with inter-device differences.
Setting
Cornea clinic in a Tertiary referral center.
Methods
This cross-sectional study included 46 eyes of 36 patients after penetrating keratoplasty (PKP), Descemet’s stripping automated endothelial keratoplasty (DSAEK), or Descemet membrane endothelial keratoplasty (DMEK). All eyes underwent standardized IOP measurement with both GAT and ICH on the same visit by masked examiners. The primary outcome was the absolute inter-method difference (|GAT–ICH|). Secondary analyses included the signed difference (GAT–ICH) and correlations of inter-device differences and single-device IOPs with best-corrected visual acuity (BCVA), years since transplantation, and glaucoma treatment status.
Results
GAT readings were significantly higher than ICH (mean arithmetic difference 2.43 ± 3.90 mmHg, mean absolute difference 3.60 ± 2.84 mmHg; p = 6.99 × 10⁻⁵). Bland–Altman analysis showed a mean bias of 2.43 mmHg with 95% limits of agreement −5.23 to 10.08 mmHg. By graft type, mean arithmetic GAT–ICH differences were 3.48 mmHg in PKP, 1.11 mmHg in DSAEK, and 3.60 mmHg in DMEK. Paired testing demonstrated significant inter-device differences in PKP (p = 0.006) and DMEK (p = 0.0049), but not in DSAEK. Absolute differences did not differ significantly among graft types (p = 0.269).
Conclusions
ICH provides clinically useful IOP estimates in eyes with corneal transplants but exhibits systematic bias relative to GAT, particularly in PKP and DMEK eyes where the largest discrepancies were observed. Neither visual acuity, graft age, nor glaucoma therapy reliably predicted inter-device disagreement, underscoring the need for individualized IOP assessment and confirmation of absolute IOP values with GAT when therapeutic decisions are required.