International Ophthalmology

, Volume 38, Issue 3, pp 959–966 | Cite as

Repeatability and agreement of central corneal thickness measurement with non-contact methods: a comparative study

  • Tarannum Mansoori
  • Nagalla Balakrishna
Original Paper



To compare the central corneal thickness (CCT) measurements and reliability of RTVue XR-100 anterior segment optical coherence tomography (AS-OCT), AL-scan optical biometer and Schwind Sirius anterior segment analysis system.


The CCT was measured in one hundred and twenty-seven eyes of 127 healthy subjects with AS-OCT, AL-scan and Sirius system. Mean CCT was compared among the instruments, and the level of agreement was assessed using Bland–Altman plots. One eye each of 30 subjects was randomly assigned for intrasession intraoperator and interoperator repeatability which was assessed using coefficient of variation and intraclass correlation coefficient.


Mean CCT with AS-OCT, AL-scan and Sirius system was 496.72 ± 32.75, 507.43 ± 33.54 and 512.08 ± 33.1 µm, respectively. There was no statistically significant difference between AL-scan and Sirius system (p = 0.26). Significant difference was found between AS-OCT/AL-scan (p = 0.01) and AS-OCT/Sirius system (p < 0.0001). Bland–Altman analysis showed a high level of agreement between AL-Scan/Sirius system (Mean difference −4.6 µm) and a low level of agreement between AS-OCT/AL-scan (Mean difference −10.7 µm) and OCT/Sirius system (Mean difference −15.4 µm).


AS-OCT underestimated CCT measurements when compared to other two devices in healthy subjects. Hence, one must be cautious when analyzing the results from different machines and should be aware that the measurement values are not interchangeable.


CCT measurement RTVue XR-100 anterior segment optical coherence tomography AL-scan optical biometer Schwind Sirius anterior segment analysis system 


Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Seiler T, Koufala K, Richter G (1998) Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg 14:312–317PubMedGoogle Scholar
  2. 2.
    Thomas R, Korah S, Muliyil J (2000) The role of central corneal thickness in the diagnosis of glaucoma. Indian J Ophthalmol 48:107–111PubMedGoogle Scholar
  3. 3.
    Doughty MJ, Zaman ML (2000) Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. Surv Ophthalmol 44:367–408CrossRefPubMedGoogle Scholar
  4. 4.
    Bayhan HA, Bayhan SA, Can I (2014) Comparison of central corneal thickness measurements with three new optical devices and a standard ultrasonic pachymeter. Int J Ophthalmol 7:302–308PubMedPubMedCentralGoogle Scholar
  5. 5.
    Nam SM, Im CY, Lee HK, Kim EK, Kim TI, Seo KY (2010) Accuracy of RTVue optical coherence tomography, Pentacam, and ultrasonic pachymetry for the measurement of central corneal thickness. Ophthalmology 117:2096–2103CrossRefPubMedGoogle Scholar
  6. 6.
    Zhao PS, Wong TY, Wong WL, Saw SM, Aung T (2007) Comparison of central corneal thickness measurements by visante anterior segment optical coherence tomography with ultrasound pachymetry. Am J Ophthalmol 143:1047–1049CrossRefPubMedGoogle Scholar
  7. 7.
    Ishibazawa A, Igarashi S, Hanada K, Nagaoka T, Ishiko S, Ito H et al (2011) Central corneal thickness measurements with Fourier-domain optical coherence tomography versus ultrasonic pachymetry and rotating Scheimpflug camera. Cornea 30:615–619CrossRefPubMedGoogle Scholar
  8. 8.
    Li EY, Mohamed S, Leung CK, Rao SK, Cheng AC, Cheung CY et al (2007) Agreement among 3 methods to measure corneal thickness: ultrasound pachymetry, Orbscan II, and Visante anterior segment optical coherence tomography. Ophthalmology 114:1842–1847CrossRefPubMedGoogle Scholar
  9. 9.
    Li H, Leung CK, Wong L, Cheung CY, Pang CP, Weinreb RN et al (2008) Comparative study of central corneal thickness measurement with slit-lamp optical coherence tomography and visante optical coherence tomography. Ophthalmology 115:796–801CrossRefPubMedGoogle Scholar
  10. 10.
    Milla M, Piñero DP, Amparo F, Alió JL (2011) Pachymetric measurements with a new Scheimpflug photography-based system: intraobserver repeatability and agreement with optical coherence tomography pachymetry. J Cataract Refract Surg 37:310–316CrossRefPubMedGoogle Scholar
  11. 11.
    Huang J, Ding X, Savini G, Jiang Z, Pan C, Hua Y et al (2014) Central and midperipheral corneal thickness measured with Scheimpflug imaging and optical coherence tomography. PLoS ONE 9:e98316. doi: 10.1371/journal.pone.0098316 (eCollection 2014) CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Huang J, Ding X, Savini G, Pan C, Feng Y, Cheng D et al (2013) A comparison between Scheimpflug imaging and optical coherence tomography in measuring corneal thickness. Ophthalmology 120:1951–1958CrossRefPubMedGoogle Scholar
  13. 13.
    Yazici AT, Bozkurt E, Alagoz C, Alagoz N, Pekel G, Kaya V et al (2010) Central corneal thickness, anterior chamber depth, and pupil diameter measurements using Visante OCT, Orbscan, and Pentacam. J Refract Surg 26:127–133CrossRefPubMedGoogle Scholar
  14. 14.
    Shimmyo M, Ross AJ, Moy A, Mostafavi R (2003) Intraocular pressure, Goldmann applanation tension, corneal thickness, and corneal curvature in Caucasians, Asians, Hispanics, and African Americans. Am J Ophthalmol 136:603–613CrossRefPubMedGoogle Scholar
  15. 15.
    Aghaian E, Choe JE, Lin S, Stamper RL (2004) Central corneal thickness of Caucasians, Chinese, Hispanics, Filipinos, African Americans, and Japanese in a glaucoma clinic. Ophthalmology 111:2211–2219CrossRefPubMedGoogle Scholar
  16. 16.
    Vijaya L, George R, Baskaran M, Arvind H, Raju P, Ramesh SV et al (2008) Prevalence of primary open-angle glaucoma in an urban south Indian population and comparison with a rural population. The Chennai Glaucoma Study. Ophthalmology. 115:648–654CrossRefPubMedGoogle Scholar
  17. 17.
    Nangia V, Jonas JB, Sinha A, Matin A, Kulkarni M (2010) Central corneal thickness and its association with ocular and general parameters in Indians: the Central India eye and medical study. Ophthalmology 117:705–710CrossRefPubMedGoogle Scholar
  18. 18.
    Rochtchina E, Mitchell P, Wang JJ (2002) Relationship between age and intraocular pressure: the Blue Mountains Eye Study. Clin Exp Ophthalmol 30:173–175CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Sita Lakshmi Glaucoma CenterAnand Eye InstituteHabsiguda, HyderabadIndia
  2. 2.Department of StatisticsNational Institute of NutritionHyderabadIndia

Personalised recommendations