Disinfection of the Goldman applanation tonometer: a systematic review

The Goldmann applanation tonometer is the gold standard for measuring intraocular pressure and a possible vector for the transmission of infectious diseases. The purpose of this study is to consolidate the evidence pertaining to the disinfection of Goldmann tonometers in an effort to facilitate an informed discussion regarding public policy in this important area. Systematic review. An exhaustive literature review was undertaken to identify primary-level research that assesses the effectiveness of different agents used in the disinfection of Goldmann applanation tonometer prisms. Seven discrete databases were reviewed by 2 independent researchers, and a symmetrical screening process was used to identify and review all pertinent studies. Our review identified only 19 primary-level studies that relate specifically to the disinfection of Goldmann tonometer prisms. These studies are largely heterogeneous with regard to the pathogens and disinfectants that were tested and the experimental protocols that were employed. Accordingly, definitive conclusions as to the optimal agent cannot be made on this basis. Furthermore, the results of our review reinforce previous suggestions that only adenovirus has been transmitted between patients via the Goldmann tonometer. The present state of the literature does not permit a definitive conclusion regarding optimal disinfection agent for Goldmann applanation tonometer prisms. Further well-constructed studies are required to better delineate the effectiveness of disinfectants in the specific context of tonometer prisms. Le tonomètre à aplanation Goldmann, appareil de référence pour mesurer la pression intraoculaire, constitue un vecteur possible de transmission d’infections. La présente étude vise à rassembler les données sur la stérilisation des tonomètres Goldmann en vue d’encourager une discussion éclairée sur les politiques publiques régissant cette sphère de grande importance. Revue de synthèse systématique. Une revue de synthèse exhaustive de la littérature médicale a été entreprise pour découvrir les études originales qui se penchent sur l’efficacité de différents agents utilisés dans la désinfection des prismes pour tonomètre à aplanation Goldmann. Sept bases de données discrètes ont été passées en revue par 2 chercheurs indépendants, et un processus de sélection symétrique a servi à identifier et à examiner toutes les études pertinentes. Notre revue de synthèse a permis de retracer seulement 19 études originales qui