Tonometrie: Rückblick und Ausblick (Teil 2)

Zusammenfassung

In 2. Teil des Beitrags werden die sonstigen Kontakttonometer und die Nonkontakttonometrie präsentiert. Es wird anhand einer Revue der Literatur über den klinischen Wert der verschiedenen Methoden und den Wert der Multimodalität in der Tonometrie diskutiert; ferner werden die letzten Innovationen mit den telemetrischen IOD-Sensoren eingeführt.

Abstract

Reliable and repeated IOP measurement are essential in the diagnosis and treatment of glaucoma. In this second part, the other contact tonometry and non-contact tonometry are presented. The clinical value of the different methods and the value of multimodality in tonometry will be discussed based on a review of the literature, and the latest innovations with telemetric IOP sensors will be introduced.

Kernaussagen

• Der Beitrag stellt die verschiedenen Methoden zur Tonometrie mit den entsprechenden spezifischen Vor- und Nachteilen gegenüber.

• Nachdem im 1. Teil die physiologischen Voraussetzungen ebenso wie die physikalischen Grundlagen der Tonometrie dargestellt wurden, sind hier die kontakttonometrischen Verfahren der portablen Applanationstonometer, die dynamische Konturtonometrie und die ballistische (Rebound-)Tonometrie thematisiert.

• Nonkontakttonometer umfassen die Luftstoß-Nonkontakttonometrie, eine auf dem Applanationsprinzip basierende Methode.

• Die Messung der kornealen Biomechanik stellt ein zusätzliches Instrument zur Diagnose des Glaukoms dar.

• Die von Goldmann Mitte des letzten Jahrhunderts etablierte Applanationstonometrie mit herkömmlichen Prismen gilt nach wie vor als absoluter Goldstandard bei der Bestimmung des intraokularen Druckes (IOD).

• Bei Kindern ist zu beachten, dass möglichst ein kinderfreundliches Verfahren gewählt wird. Auch sollte Ketanest anstelle von Halotanen und Fluranen verwendet werden, sofern die Untersuchung doch in Narkose stattfindet.

• Systeme zur Selbsttonometrie sind verfügbar, allerdings noch nicht hinreichend untersucht und nicht für alle Patienten geeignet. Telemetrische Messungen könnten die Nachteile ausgleichen.

Schlüsselwörter

Nonkontakttonometrie - Augeninnendruck - intraokularer Druck - IOD - Glaukom - ophthalmologische Diagnostik - portable Tonometrie - Selbsttonometrie - telemetrische Verfahren

Key words

tonometry - review - Goldmann Tonometry - non-contact tonometry - telemetric sensors

Publication History

Article published online:
22 February 2023

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