diaton tonometer through the lid new approvals
Interesting product - I saw diaton tonometer at the Congress in London about 2-3 years ago and it seems to be gaining momentum and is spreading to other countries - I see BiCOM got new approvals in Mexico and Canada and it already has CE and FDA. I just visited their site and looked at the training video - looks easy and quick. I found 2 comparative studies at ASCRS - the second study states that it's good for both adults and kids. I see how children may like it better vs. invasive methods, even the puff and it's reasonably priced at 2495 USD
Here are the links to the abstracts of the comparisons of diaton vs goldmann vs tonopen - it was presented at American Society of Cataract and Refractive Surgery (ASCRS) meeting in 2007
1. Abstract from ASCRS by Dr. Richard Davidson http://ascrs2007.abstractsnet.com/acover.wcs?entryid=000125
2. Abstract from ASCRS by Dr. Malik Kahook http://ascrs2007.abstractsnet.com/acover.wcs?entryid=000127
I extracted them here:
1. Comparison of the Diaton Transpalpebral Tonometer Versus Goldmann Applanation
R. S. Davidson 1; N. Faberowski2 ; R. J. Noecker3 ; M. Y. Kahook1
1. Ophthalmology, Rocky Mountain Lions Eye Institute, Aurora, CO, USA.
2. Ophthalmology, Denver Health Medical Center, Denver, CO, USA.
3. Ophthalmology, UPMC, Pittsburgh, PA, USA.
Financial Disclosure
The authors have no financial interest in the subject matter being presented
Background
Diaton tonometry is a unique approach to measuring intraocular pressure (IOP) through the Eyelid. It is a non-contact (no contact with cornea), pen like, hand-held, portable tonometer. It requires no anesthesia or sterilization.
Purpose
To investigate the agreement in the measurement of intraocular pressure (IOP) obtained by transpalpebral tonometry using the Diaton tonometer versus Goldmann applanation in adult patients presenting for routine eye exams.
Methods
Retrospective chart review of consecutive IOP measurements performed on 64 eyes of 32 patients age 34-91 years with both the Diaton tonometer and Goldmann applanation. Results between groups were examined using analysis of variance (ANOVA) where appropriate.
Results
Mean IOP was 15.09 +/-4.31 mm Hg in the Goldmann group and 15.70 +/-4.33 mm Hg in the Diaton group (p=0.43).
Mean IOP variation between groups was 1.74 +/-1.42 mm Hg (range 0-8). 83% of all measurements were within 2 mm Hg of each other.
Conclusions
The transpalpebral method of measuring IOP with the Diaton tonometer correlates well with Goldmann applanation. Diaton applanation may be a clinically useful device for measuring IOP in routine eye exams.
2. Comparison of the Diaton Transpalpebral Tonometer Versus Tono-Pen Applanation
Theodore H. Curtis, M.D.1, Douglas L Mackenzie, M.D.1, Robert J. Noecker M.D.2, and Malik Y. Kahook M.D.1
1The Rocky Mountain Lions Eye Institute, University of Colorado Health Sciences Center, Aurora, CO
2Eye and Ear Institute, University of Pittsburgh Medical Center, Pittsburgh, PA
Financial Disclosures
· None of the authors have financial interests relevant to the supject discussed.
Purpose
· To compare intraocular pressure (IOP) measurements obtained with Diaton trans-palpebral tonometry versus Tonopen applanation tonometry in children and adults.
Introduction
· Goldmann applanation is the gold standard for IOP measurement
· It has been supplanted by TonoPen applanation in many settings because of it's ease of use, portability, convenience, and minimal training requirements.
· The TonoPen requires contact with the corneal surface, and has the risks of iatrogenic corneal injury, spread of pathogens, and requires topical anesthetics.
Introduction
· The newly-developed Diaton tonometer is a handheld device that measures pressure through the tarsal plate (Figures 1 & 2).
· It avoids contact with the cornea and the need for topical anesthesia.
Figure 1: The Diaton Transpalpebral Tonometer
Figure 2: Using the Diaton Tonometer
Methods
· We looked at 74 eyes of 38 consecutive patients who received both Tonopen and Diaton tonometry
· TonoPen measurements were taken in the sitting position following topical anesthesia with proparicaine.
· Diaton measurements were performed in the sitting position with the patient gazing at a 45o angle, placing the eyelid margin at the superior limbus. If necessary, gentle traction was placed on the brow to align the lid with the limbus. The device was activated when the signaling mechanism indicated the device was vertical.
Results
· Age range 3-91 years of age (mean 47.5 years).
· The average IOP with the Diaton was 16.24 (+/-5.11 mm Hg; range = 7-32 mmHg).
· The average IOP with the TonoPen was 16.37 (+/-4.90 mm Hg; range = 8-33 mmHg).
· The mean variation between the two modalities was 1.59 mmHg (+/-1.31 mm Hg; range = 0-6 mmHg).
· Eighty-one percent of all measurements were within 2 mmHg of each other (Table 1).
· There was no statistically significant difference in mean IOP values obtained with the two devices (p=0.87). Table
Conclusions
· The Diaton tonometer pressure measurements correlated well with TonoPen measurements in this retrospective review.
· We did not find problems performing the exam in children, and many were reassured by the fact that no drops were needed.
· There may be a notable benefit in patients after refractive surgery or with corneal pathology since the Diaton does not applanate the cornea.
· The Diaton tonometer appears to be a clinically useful device in the IOP measurement of both children and adults.
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