Abstract
Purpose
To provide normal corneal elevation data for a large Caucasian population and to determine the impacts on these data of age, sex, axial length (AXL) and horizontal white-to-white (WW).
Setting
Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
Design
Retrospective, cross-sectional, observational.
Methods
In this retrospective, cross-sectional, observational study, anterior and posterior corneal elevations were measured in 789 right eyes of subjects with no ocular disease at the thinnest corneal location in relation to a fixed 8-mm best-fit sphere using the Pentacam, and AXL and WW were measured with the IOLMaster. A multiple linear regression model was used to assess the effects of age, sex, AXL and WW on the elevation data.
Results
Mean subject age was 50.5 ± 15 years (range 17–93 years); 64% were women. Mean anterior and posterior corneal elevations were 1.99 ± 1.75 µm (− 7 to 10 µm) and 7.70 ± 5.7 µm (− 6 to 28 µm). Anterior corneal elevations were higher by 0.165 μm and 0.033 μm for every mm reduction in AXL and every year reduction in age, respectively. Sex and WW were not significant predictors of anterior elevations (R2 = 7.7%). Posterior corneal elevation increased by 0.186 μm/year of age, 0.707 μm/mm reduction in WW and 0.819 μm/mm reduction in AXL. This variable was also 0.866 μm greater in men (R2 = 34.4%).
Conclusion
Anterior corneal elevations decrease with age and are higher for shorter AXL but are not influenced by sex or WW. Posterior corneal elevations increase with age, decreasing AXL, decreasing WW and are higher in men.
Similar content being viewed by others
References
Wen D, McAlinden C, Flitcroft I et al (2017) Postoperative efficacy, predictability, safety, and visual quality of laser corneal refractive surgery: a network meta-analysis. Am J Ophthalmol 178:65–78. https://doi.org/10.1016/j.ajo.2017.03.013
Santhiago M, Giacomin N, Smadja D, Bechara S (2016) Ectasia risk factors in refractive surgery. Clin Ophthalmol 10:713–720. https://doi.org/10.2147/opth.s51313
de Sanctis U, Loiacono C, Richiardi L et al (2008) Sensitivity and specificity of posterior corneal elevation measured by Pentacam in discriminating keratoconus/subclinical keratoconus. Ophthalmology 115:1534–1539. https://doi.org/10.1016/j.ophtha.2008.02.020
Ambrósio R, Faria-Correia F, Ramos I et al (2013) Enhanced screening for ectasia susceptibility among refractive candidates: the role of corneal tomography and biomechanics. Curr Ophthalmol Rep 1:28–38. https://doi.org/10.1007/s40135-012-0003-z
Bae GH, Kim JR, Kim CH et al (2014) Corneal topographic and tomographic analysis of fellow eyes in unilateral keratoconus patients using Pentacam. Am J Ophthalmol 157(103–109):e1. https://doi.org/10.1016/j.ajo.2013.08.014
Gomes JA, Tan D, Rapuano CJ et al (2015) Global consensus on keratoconus and ectatic diseases. Cornea 34:359–369
Kim JT, Cortese M, Belin MW, Ambrosio R Jr, Khachikian SS (2011) Tomographic normal values for corneal elevation and pachymetry in a hyperopic population. J Clin Exp Ophthalmol 2:130. https://doi.org/10.4172/2155-9570.1000130
Ambrósio R, Randleman JB (2013) Screening for ectasia risk: what are we screening for and how should we screen for it? J Refract Surg 29:230–232. https://doi.org/10.3928/1081597x-20130318-01
Kovács I, Miháltz K, Ecsedy M et al (2011) The role of reference body selection in calculating posterior corneal elevation and prediction of keratoconus using rotating Scheimpflug camera. Acta Ophthalmol (Copenh) 89:e251–e256. https://doi.org/10.1111/j.1755-3768.2010.02053.x
Henriquez MA, Izquierdo L, Dañin D (2014) Corneal elevation values in normal eyes, forme fruste keratoconus and keratoconus at different stages measured by Scheimpflug imaging. Int J Keratoconus Ectatic Corneal Dis 3:36–39. https://doi.org/10.5005/jp-journals-10025-1075
Muftuoglu O, Ayar O, Ozulken K et al (2013) Posterior corneal elevation and back difference corneal elevation in diagnosing forme fruste keratoconus in the fellow eyes of unilateral keratoconus patients. J Cataract Refract Surg 39:1348–1357. https://doi.org/10.1016/j.jcrs.2013.03.023
de Sanctis U, Aragno V, Dalmasso P et al (2013) Diagnosis of subclinical keratoconus using posterior elevation measured with 2 different methods. Cornea 32:911–915. https://doi.org/10.1097/ico.0b013e3182854774
Hernández-Camarena JC, Chirinos-Saldaña P, Navas A et al (2014) Repeatability, reproducibility, and agreement between three different Scheimpflug systems in measuring corneal and anterior segment biometry. J Refract Surg 30:616–621. https://doi.org/10.3928/1081597x-20140815-02
Khachikian SS, Belin MW (2009) Posterior elevation in keratoconus. Ophthalmology 116:816
Guilbert E, Saad A, Grise-Dulac A, Gatinel D (2012) Corneal thickness, curvature, and elevation readings in normal corneas: combined Placido–Scheimpflug system versus combined Placido–scanning-slit system. J Cataract Refract Surg 38:1198–1206. https://doi.org/10.1016/j.jcrs.2012.01.033
Smadja D, Santhiago MR, Mello GR et al (2013) Influence of the reference surface shape for discriminating between normal corneas, subclinical keratoconus, and keratoconus. J Refract Surg Thorofare NJ 29:274–281. https://doi.org/10.3928/1081597x-20130318-07
Mostafa EM (2017) Comparison between corneal elevation maps using different reference surfaces with Scheimpflug–Placido topographer. Int Ophthalmol 37:553–558. https://doi.org/10.1007/s10792-016-0291-7
Feng MT, Belin MW, Ambrósio R et al (2011) International values of corneal elevation in normal subjects by rotating Scheimpflug camera. J Cataract Refract Surg 37:1817–1821. https://doi.org/10.1016/j.jcrs.2011.04.030
Gilani F, Cortese M, Ambrósio RR et al (2013) Comprehensive anterior segment normal values generated by rotating Scheimpflug tomography. J Cataract Refract Surg 39:1707–1712. https://doi.org/10.1016/j.jcrs.2013.05.042
Ruiseñor Vázquez PR, Galletti JD, Minguez N et al (2014) Pentacam Scheimpflug tomography findings in topographically normal patients and subclinical keratoconus cases. Am J Ophthalmol 158(32–40):e2. https://doi.org/10.1016/j.ajo.2014.03.018
Hashemi H, Beiranvand A, Khabazkhoob M et al (2016) Corneal elevation and keratoconus indices in a 40- to 64-year-old population, Shahroud Eye Study. J Curr Ophthalmol 27:92–98. https://doi.org/10.1016/j.joco.2015.10.007
Orucoglu F, Toker E (2015) Comparative analysis of anterior segment parameters in normal and keratoconus eyes generated by Scheimpflug tomography. J Ophthalmol 2015:1–8. https://doi.org/10.1155/2015/925414
Correia FF, Ramos I, Lopes B et al (2012) Topometric and tomographic indices for the diagnosis of keratoconus. Int J Keratoconus Ectatic Corneal Dis 1:92–99
Ying J, Wang Q, Belin MW et al (2016) Corneal elevation in a large number of myopic Chinese patients. Contact Lens Anterior Eye J Br Contact Lens Assoc 39:185–190. https://doi.org/10.1016/j.clae.2016.01.005
Muftuoglu O, Ayar O, Hurmeric V et al (2015) Comparison of multimetric D index with keratometric, pachymetric, and posterior elevation parameters in diagnosing subclinical keratoconus in fellow eyes of asymmetric keratoconus patients. J Cataract Refract Surg 41:557–565. https://doi.org/10.1016/j.jcrs.2014.05.052
Gatinel D, Malet J, Hoang-Xuan T, Azar DT (2011) Corneal elevation topography: best fit sphere, elevation distance, asphericity, toricity and clinical implications. Cornea 30:508–515. https://doi.org/10.1097/ico.0b013e3181fb4fa7
Mahroo OA, Oomerjee M, Williams KM et al (2014) High heritability of posterior corneal tomography, as measured by Scheimpflug imaging, in a twin study. Invest Ophthalmol Vis Sci 55:8359–8364. https://doi.org/10.1167/iovs.14-15043
López-Montemayor P, Valdez-García JE, Loya-García D, Hernandez-Camarena JC (2017) Safety, efficacy and refractive outcomes of LASIK surgery in patients aged 65 or older. Int Ophthalmol. https://doi.org/10.1007/s10792-017-0614-3
Hashemi M, Falavarjani KG, Aghai GH et al (2013) Anterior segment study with the Pentacam Scheimpflug camera in refractive surgery candidates. Middle East Afr J Ophthalmol 20:212. https://doi.org/10.4103/0974-9233.114793
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standards
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 was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Almorín-Fernández-Vigo, I., Sánchez-Guillén, I., Fernández-Vigo, J.I. et al. Normative Pentacam anterior and posterior corneal elevation measurements: effects of age, sex, axial length and white-to-white. Int Ophthalmol 39, 1955–1963 (2019). https://doi.org/10.1007/s10792-018-1028-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-018-1028-6