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¹GATA Haydarpaşa Eğitim Hastanesi Göz Hastalıkları Servisi, İstanbul, Yrd. Doç. Dr.
²GATA Haydarpaşa Eğitim Hastanesi Göz Hastalıkları Servisi, İstanbul, Doç. Dr.
³İ.Ü. Cerrahpaşa Tıp Fakültesi Halk Sağlığı A.D., İstanbul, Uzm. Dr.
⁴GATA Haydarpaşa Eğitim Hastanesi Göz Hastalıkları Servis Şefi, İstanbul, Prof. Dr. Purpose: To assess the effect of two different types of eyelid speculum (wire and solid blade) on intraocular pressure measurements.
Materials and Methods: Sixty eyes of 60 consecutive patients hospitalized for cataract surgery were included in the study. IOP was measured under topical anesthesia, in a supine position using a Perkins manual tonometer. IOP was measured three times (without a speculum, with a wire speculum, and with a solid blade speculum) with intervals of one hour between the measurements. The subjects were excluded if they did not allow reliable IOP measurements due to involuntary eye movements or Bell’s phenomenon.
Results: Fifty-one eyes of 51 patients who allowed reliable IOP measurements were enrolled in the study. Mean age was 69.8 ± 11.4 years (range 21 to 88 years). Twenty-seven of the 51 subjects (52.9%) were male and 24 (47.1%) were female. The mean IOP without the speculum was 15.0 ± 3.27 mmHg. With the wire and solid blade specula in place the mean IOPs were 16.5 ± 3.09 and 14.7 ± 3.18 mmHg, respectively. The IOP measurements with the wire speculum were significantly higher than those with the solid blade speculum and without the speculum (paired t test, p<0.001).
Conclusion: The wire speculum causes a significant artifactual elevation in IOP measurements. This should be considered in ophthalmic operations in which IOP changes are important. Keywords : Eyelid speculum, intraocular pressure, ophthalmic surgery