Tonometrie: Rückblick und Ausblick (Teil 1)

Zusammenfassung

Der intraokulare Druck (IOD) ist ein wichtiger physikalischer Parameter der Physiologie des Auges. Ein erhöhter IOD wurde früh als Ätiologie für Augenerkrankungen vermutet. In diesem 1. Teil des Beitrags wird neben den physiologischen Grundlagen die Kontakttonometrie vorgestellt, die sowohl die erste instrumentelle Methode mit den Indentationstonometern als auch den Goldstandard mit dem Goldmann-Applanationstonometer darstellt.

Abstract

Reliable and repeated IOP measurement are essential in the diagnosis and treatment of glaucoma. In this first part of this review, besides the physiological basics, contact tonometry will be presented, which is both the first instrumental method with the indentation tonometers and the gold standard with the Goldmann applanation tonometer. Both methods and subsequently developments will be discussed.

Kernaussagen

• In der Diagnose und Behandlung des Glaukoms ist eine zuverlässige und wiederholte IOD-Messung des Augeninnendrucks (intraokularer Druck; IOD) essenziell.

• Der IOD resultiert aus dem Gleichgewicht der Kammerwassersekretion und dem Kammerwasserabfluss. Ein erhöhter IOD kann das Ergebnis einer verstärkten Produktion (sehr selten) oder generell einer Behinderung des Abflusses sein.

• Die Entwicklung der Indentationstonometrie erlaubte die erste objektive reliable apparative Messung. Sie wurde durch die Applanationstonometrie und das Goldtonometer verbessert.

• Die Goldmann-Applanationstonometrie ermöglicht es, das durch die Indentationstonometrie verdrängte Kammerwasservolumen zu vernachlässigen, und stellt somit seit ihrer Entwicklung die robusteste Methode und den Goldstandard dar. Insbesondere bei Z. n. Vitrektomie ist das Goldmann-Tonometer anderen Tonometern eindeutig überlegen.

• Mobile Varianten wurden in der Folge entwickelt, um über die Möglichkeit zu verfügen, Messungen im Liegen durchzuführen. So ist das Perkins-Tonometer quasi ein mobiles Goldmann-Tonometer. Das Ocuton-Tonometer ermittelt den IOD elektronisch und wurde zur Selbsttonometrie entwickelt.

Schlüsselwörter

Goldmann-Tonometrie - Augeninnendruck - intraokularer Druck - IOD - Glaukom - ophthalmologische Diagnostik

Key words

tonometry - Goldmann tonometry - non contact tonometry - telemetric sensors - intraocular pressure - IOP

Publication History

Article published online:
17 November 2022

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