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Purpose: To evaluate two specular microscopy analysis methods across different endothelial cell densities (ECDs).Methods: Endothelial images of one eye from each of 45 patients were taken by using three different specular microscopes (three replicates each). To determine the consistency of the center-dot method, we compared SP-6000 and SP-2000P images. CME-530 and SP-6000 images were compared to assess the consistency of the fully automated method. The SP-6000 images from the two methods were compared. Intraclass correlation coefficients (ICCs) for the three measurements were calculated, and parametric multiple comparisons tests and Bland-Altman analysis were performed.Results: The ECD mean value was 2425 ± 883 (range 516-3707) cells/mm2. ICC values were > 0.9 for all three microscopes for ECD, but the coefficients of variation (CVs) were 0.3-0.6. For ECD measurements, Bland-Altman analysis revealed that the mean difference was 42 cells/mm2 between the SP-2000P and SP-6000 for the center-dot method; 57 cells/mm2 between the SP-6000 measurements from both methods; and −5 cells/mm2 between the SP-6000 and CME-530 for the fully automated method (95% limits of agreement: − 201 to 284 cell/mm2, − 410 to 522 cells/mm2, and − 327 to 318 cells/mm2, respectively). For CV measurements, the mean differences were − 3, − 12, and 13% (95% limits of agreement − 18 to 11, − 26 to 2, and − 5 to 32%, respectively).Conclusions: Despite using three replicate measurements, the precision of the center-dot method with the SP-2000P and SP-6000 software was only ± 10% for ECD data and was even worse for the fully automated method.Clinical trial registration: Japan Clinical Trials Register (http://www.umin.ac.jp/ctr/index/htm9) number UMIN 000015236. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the inter-device agreement among the Goldmann applanation tonometer (GAT), iCare and Icare PRO rebound tonometers, non-contact tonometer (NCT), and Tonopen XL tonometer.Methods: Sixty healthy elderly subjects were enrolled. The intraocular pressure (IOP) in each subject’s right eye was measured thrice using each of the five tonometers. Intra-device agreement was evaluated by calculating intraclass correlation coefficients (ICCs). Inter-device agreement was evaluated by ICC and Bland-Altman analyses.Results: ICCs for intra-device agreement for each tonometer were >0.8. IOP as measured by iCare (mean ± SD, 11.6 ± 2.5 mmHg) was significantly lower (p < 0.05) than that measured by GAT (14.0 ± 2.8 mmHg), NCT (13.6 ± 2.5 mmHg), Tonopen XL (13.7 ± 4.1 mmHg), and Icare PRO (12.6 ± 2.2 mmHg; Bonferroni test). There was no significant difference in mean IOP among GAT, NCT, and Tonopen XL. Regarding inter-device agreement, ICC was lower between Tonopen XL and other tonometers (all ICCs < 0.4). However, ICCs of GAT, iCare, Icare PRO, and NCT showed good agreement (0.576-0.700). The Bland-Altman analysis revealed that the width of the 95% limits of agreement was larger between the Tonopen XL and the other tonometers ranged from 14.94 to 16.47 mmHg. Among the other tonometers, however, the widths of 95% limits of agreement ranged from 7.91 to 9.24 mmHg.Conclusion: There was good inter-device agreement among GAT, rebound tonometers, and NCT. Tonopen XL shows the worst agreement with the other tonometers; therefore, we should pay attention to its’ respective IOP.Clinical trial registration: Japan Clinical Trials Register; number: UMIN000011544. [ABSTRACT FROM AUTHOR]