In this prospective study of sequential children undergoing intraocular surgery, IOP was measured immediately following general anesthesia induction using both Icare PRO rebound tonometry and Tono-Pen XL tonometry, with instrument order randomized, in the supine child's eye(s). At completion of surgery after standard placement of intracameral air IOP was again measured using both instruments.
A total of 42 eyes of 30 children were included. Surgeries included glaucoma (25), cataract-related (16), and both (1). Mean preoperative IOP by Tono-Pen XL was 23.52 ± 9.76 mm Hg; by Icare PRO, 20.94 ± 10.01 mm Hg (P = 0.0012). Mean IOP over intracameral air at surgery conclusion by Tono-Pen XL (n = 41) was 12.66 ± 4.90; by Icare PRO (n = 42), 12.96 ± 5.10 mm Hg (P = 0.46). One eye had postoperative IOP unrecordable by Tono-Pen XL but 7.9 mm Hg by Icare PRO. Bland-Altman analysis, which included only paired measurements, showed a preoperative mean difference in IOP (ΔIOPT−I) of 2.58 mm Hg (95% CI, −6.86 to 12.02); postoperative mean ΔIOPT−I of −0.42 mm Hg [95% CI, −7.57 to 6.73].
Position-independent rebound tonometry (Icare PRO) accurately measured IOP in supine children's eyes postoperatively in the presence of intracameral air.