intraocular pressure measurements by three different tonometers in children with aphakic glaucoma and a thick cornea

background: to evaluate the agreement in intraocular pressure (iop) measurements by ocular response analyzer (ora) and tono-pen xl (txl) with the goldmann applanation tonometer (gat) and to examine corneal biomechanical properties in aphakic glaucoma patients with a central corneal thickness (cct) >600 µ. methods: thirty-six eyes of aphakic glaucoma patients (group 1) and 40 eyes of normal children (group 2) were studied. the mean ora and txl iop values were compared with the gat-iop values. regression analyses were used to evaluate the associations between iop and cct, corneal hysteresis (ch), and corneal resistance factor (crf). bland-altman plots were used to evaluate the agreement between the tonometers. results: the mean±standard deviations of the age and male/female ratio were 16.58±5.44 and 15.75±5.04 years and 14/22 and 18/22 in group 1 and group 2, respectively. cct in group 1 was 651.1±42 and in group 2 was 567.3±32.4. in group 1, the mean txl (22.4, p=0.004), iopcc (corneal compensated) (27.8, p=0.005), and iopg (goldmann correlated) values (28.1, p<0.0001) were greater than gat-iop (20.6). in group 2, only iopg value (16.4) was higher than gat-iop (14.8, p=0.04). iop reading of all the tonometers were positively and negatively associated with crf and ch in the multiple regression analysis, respectively. conclusion: the txl had a greater agreement with the gat, and the ora overestimated iop in aphakic glaucoma patients. the ora and txl seemed to be affected by ch and crf.