Comparison of Intraocular Pressure Measured with AccuPen and Goldmann in a Glaucoma Consultation

Introduction: Intraocular pressure (IOP) measurement with Goldmann applanation tonometry (GAT) is currently considered the gold standard.AccuPen tonometry is a portable and rapid method, but there is no local evidence supporting its reliability.Objective: To determine whether IOP measurements obtained with AccuPen are comparable to those obtained with Goldmann tonometry. Materials and Methods:A prospective comparative study including 114 patients (228 eyes) measured with both AccuPen and Goldmann tonometry.Data collected included age, sex, glaucoma diagnosis (yes/no), and central corneal thickness (CCT).Descriptive and inferential statistics were applied, with a significance level of 5% to compare differences.Results: 69.3% of participants were female, with a mean age of 63.4 years (SD = 13.9),ranging from 17 to 87 years.Goldmann tonometry: 17.6 7.0 mmHg (SD = 6.95) (range: 6-60 mmHg).AccuPen tonometry: 18.6 7.2 mmHg (SD = 7.15) (range: 5-57 mmHg).The mean difference between methods was -0.99 mmHg (SD = 3.16) (range: -12 to 11 mmHg), which was statistically significant (p < 0.001), with a medium effect size (D = -0.3125).56.1% of cases: Goldmann > AccuPen, 30.3% of cases: AccuPen > Goldmann, 13.6% of cases: Identical measurements.Glaucoma diagnosis was present in 53.5% of cases.The mean central corneal thickness was 545.1 m (SD = 40.7)(range: 333-737 m).Bland-Altman analysis showed that all differences were within the [-6, +6] mmHg range, with 89.9% within [-5, +5], 84.6% within [-4, +4], and 77.1% within [-3, +3].Sex, glaucoma diagnosis, and CCT were analyzed as differentiation factors, with no statistically significant differences observed. Conclusions:There is a significant difference between both methods, with only a small fraction of identical measurements, making them non-interchangeable.However, the majority of differences fell within 3 mmHg, suggesting that AccuPen could be a reasonable alternative for screening and in cases where Goldmann tonometry is not feasible.