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Comparison of central corneal thickness measurement by scanning slit topography, infrared, and ultrasound pachymetry in normal and post-LASIK eyes

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Abstract

Objectives

To compare central corneal thickness (CCT) measurements by scanning slit topography (SST), infrared pachymetry (IRP), and ultrasound pachymetry (USP), and their agreement in normal and post-laser in situ keratomileusis (LASIK) eyes.

Methods

Sixty normal and 35 post-LASIK subjects were recruited. Only one eye from each subject was analyzed. Non-contact pachymetry was performed first, and the order for SST (Orbscan IIz) and IRP (Tonoref III) was randomized for each patient, to be followed by contact USP (Echoscan US-4000). Pearson’s correlation, paired t test, and Bland–Altman plots were used to investigate association, difference, and agreement among different instruments respectively.

Results

The measurements obtained with the instruments were highly correlated. Compared to CCT determined by USP (CCTUSP), CCT determined by SST (after correction with acoustic factor) (CCTSSTC) was thicker by 7 µm in normal eyes (P < 0.001). There was no significant difference between CCTSSTC and CCTUSP (P = 0.128), but a thickness-dependent deviation in post-LASIK eyes (P = 0.003). The CCT determined by IRP (CCTIRP) was thicker than CCTUSP in normal (P < 0.001) and post-LASIK eyes (P < 0.001) and demonstrated proportional overestimation with thinner corneas, with less predictable ultrasonic equivalent corneal thickness in normal eyes. Conversely, CCTIRP significantly underestimated CCT compared to CCTSST and showed increasing underestimation with thinner corneas in both normal and post-LASIK eyes (both P < 0.001).

Conclusion

Central corneal thickness determined by SST, IRP and USP were not interchangeable or interconvertible, probably attributed to difference in methodologies. Compensation with algorithms may improve agreements amongst instruments.

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References

  1. Seiler T, Koufala K, Richter G (1998) Iatrogenic keratectasia after laser in situ keratomileusis. J Refract Surg 14:312–317. https://doi.org/10.3928/1081-597X-1998051-15

    Article  CAS  PubMed  Google Scholar 

  2. Belin MW, Lim L, Rajpal RK, Hafezi F, Gomes JAP, Cochener B (2018) Corneal cross-linking: current USA status: report from the cornea society. Cornea 37:1218–1225. https://doi.org/10.1097/ICO.0000000000001707

    Article  PubMed  Google Scholar 

  3. Dueker DK, Singh K, Lin SC, Fechtner RD, Minckler DS, Samples JR, Schuman JS (2007) Corneal thickness measurement in the management of primary open-angle glaucoma: a report by the Amercian academy of ophthalmology. Ophthalmology 114:1779–1787. https://doi.org/10.1016/j.ophtha.2007.04.068

    Article  PubMed  Google Scholar 

  4. National Institute for Health Care and Excellence (2017) Glaucoma: diagnosis and management. NICE Guideline [NG81] https://www.nice.org.uk/guidance/ng81. Assessed 12 Feb 2020

  5. The Royal College of Ophthalmologists (2016) Commissioning guide: Glaucoma. https://www.rcophth.ac.uk/wp-content/uploads/2016/06/Glaucoma-Commissioning-Guide-Long-June-2016-Final.pdf Assessed 12 Feb 2020.

  6. Salz JJ, Azen SP, Berstein J, Caroline P, Villasenor RA, Schanzlin DJ (1983) Evaluation and comparison of sources of variability in the measurement of corneal thickness with ultrasonic and optical pachymeters. Ophthalmic Surg 14:750–754

    CAS  PubMed  Google Scholar 

  7. Technolas Perfect Vision GmbH: Zyoptix Orbscan IIz. Anterior Segment Analyzer—Operator's Manual, Version 3A, München, Germany, 2009, pp 1–1, 6–13

  8. Liu Z, Huang AJ, Pflugfelder SC (1999) Evaluation of corneal thickness and topography in normal eyes using the Orbscan corneal topography system. Br J Ophthalmol 83:774–778. https://doi.org/10.1136/bjo.83.7.774

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Auto Ref/Kerato/Tono/Pachymeter Tonoref III: Operator's manual (2015) Nidek, Gamagori, Aichi, Japan, pp 12

  10. Fakhry MA, Artola A, Belda JI, Ayala MJ, Alio JL (2002) Comparison of corneal pachymetry using ultrasound and Orbscan II. J Cataract Refract Surg 28:248–252. https://doi.org/10.1016/s0886-3350(01)01277-9

    Article  PubMed  Google Scholar 

  11. Gonzalez-Meijome JM, Cervino A, Yebra-Pimentel E, Parafita MA (2003) Central and peripheral corneal thickness measurement with Orbscan II and topographical ultrasound pachymetry. J Cataract Refract Surg 29:125–132. https://doi.org/10.1016/s0886-3350(02)01815-1

    Article  PubMed  Google Scholar 

  12. Khaja WA, Grover S, Kelmenson AT, Ferguson LR, Sambhav K, Chalam KV (2015) Comparison of central corneal thickness: ultrasound pachymetry versus slit-lamp optical coherence tomography, specular microscopy, and Orbscan. Clin Ophthalmol 9:1065–1070. https://doi.org/10.2147/OPTH.S81376

    Article  PubMed  PubMed Central  Google Scholar 

  13. Suzuki S, Oshika T, Oki K, Sakabe I, Iwase A, Amano S, Araie M (2003) Corneal thickness measurements: scanning-slit corneal topography and noncontact specular microscopy versus ultrasonic pachymetry. J Cataract Refract Surg 29:1313–1318. https://doi.org/10.1016/s0886-3350(03)00123-8

    Article  PubMed  Google Scholar 

  14. Li EYM, Mohamed S, Leung CKS, Rao SK, Cheng ACK, Cheung CYL, Lam DSC (2007) Agreement among 3 methods to measure corneal thickness: ultrasound pachymetry, Orbscan II, and Visante anterior segment optical coherence tomography. Ophthalmology 114:1842–1847. https://doi.org/10.1016/j.ophtha.2007.02.017

    Article  PubMed  Google Scholar 

  15. Park SH, Choi SK, Lee D, Jun EJ, Kim JH (2012) Corneal thickness measurement using Orbscan, Pentacam, Galilei, and ultrasound in normal and post-femtosecond laser in situ keratomileusis eyes. Cornea 31:978–982. https://doi.org/10.1097/ICO.0b013e31823d03fc

    Article  PubMed  Google Scholar 

  16. Sadoughi MM, Einollahi B, Einollahi N, Rezaei J, Roshandel D, Feizi S (2015) Measurement of central corneal thickness using ultrasound Pachymetry and Orbscan II in normal eyes. J Ophthalmic Vis Res 10:4–9. https://doi.org/10.4103/2008-322X.156084

    Article  PubMed  PubMed Central  Google Scholar 

  17. McLaren JW, Nau CB, Erie JC, Bourne WM (2004) Corneal thickness measurement by confocal microscopy, ultrasound, and scanning slit methods. Am J Ophthalmol 137:1011–1020. https://doi.org/10.1016/j.ajo.2004.01.049

    Article  PubMed  Google Scholar 

  18. Hashemi H, Mehravaran S (2007) Central corneal thickness measurement with Pentacam, Orbscan II, and ultrasound devices before and after laser refractive surgery for myopia. J Cataract Refract Surg 33:1701–1707. https://doi.org/10.1016/j.jcrs.2007.05.040

    Article  PubMed  Google Scholar 

  19. Nissen J, Hjortdal JO, Ehlers N, Frost-Larsen K, Sorensen T (1991) A clinical comparison of optical and ultrasonic pachometry. Acta Ophthalmol (Copenh) 69:659–663. https://doi.org/10.1111/j.1755-3768.1991.tb04857.x

    Article  CAS  Google Scholar 

  20. Ho T, Cheng ACK, Rao SK, Lau S, Leung CKS, Lam DSC (2007) Central corneal thickness measurements using Orbscan II, Visante, ultrasound, and Pentacma pachymetry after laser in situ keratomileusis for myopia. J Cataract Refract Surg 33:1177–1182. https://doi.org/10.1016/j.jcrs.2007.03.028

    Article  PubMed  Google Scholar 

  21. Kawana K, Tokunaga T, Miyata K, Okamoto F, Kiuchi T, Oshika T (2004) Comparison of corneal thickness measurements using Orbscan II, non-contact specular microscopy, and ultrasonic pachymetry in eyes after laser in situ keratomileusis. Br J Ophthalmol 88:466–468. https://doi.org/10.1136/bjo.2003.030361

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Hafezi F, Seiler T (2010) Persistent subepithelial haze in thin-flap LASIK. J Refract Surg 26:222–225. https://doi.org/10.3928/1081597X-20090930-02

    Article  PubMed  Google Scholar 

  23. Kim EJ, Weikert MP, Martinez CE, Klyce SD (2017) Keratometry and topography. In: Mannis MJ, Holland EJ (eds) Cornea, 4th edn. Elsevier, St. Louis, pp 144–153

    Google Scholar 

  24. Boscia F, La Tegola MG, Alessio G, Sborgia C (2002) Accuracy of Orbscan optical pachymetry in corneas with haze. J Cataract Refract Surg 28:253–258. https://doi.org/10.1016/s0886-3350(01)01162-2

    Article  PubMed  Google Scholar 

  25. Desmond T, Arthur P, Watt K (2019) Comparison of central corneal thickness measurements by ultrasound pachymetry and 2 new devices, Tonoref III and RS-3000. Int Ophthalmol 39:917–923. https://doi.org/10.1007/s10792-018-0895-1

    Article  PubMed  Google Scholar 

  26. Doughty MJ, Jonuscheit S (2007) An assessment of regional differences in corneal thickness in normal human eyes, using the Orbscan II or ultrasound pachymetry. Optometry 78:181–190. https://doi.org/10.1016/j.optm.2006.08.018

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Eye Centre, Hong Kong Baptist Hospital, 222 Waterloo Road, Kowloon Tong, Hong Kong, People’s Republic of China

    Wing-cheung Ho, Philip Tsze-ho Lam, Thomas Yee-hang Chiu, Mandy Ching-man Yim & Fion Tung-ching Lau

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  1. Wing-cheung Ho
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Correspondence to Philip Tsze-ho Lam.

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The study was conducted in accordance to the Declaration of the Helsinki.

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Approval obtained from the Clinical and Research Ethics Committee of the Hong Kong Baptist Hospital (reference number: CREC-2016-03).

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Written informed consent was obtained from all subjects recruited in this study.

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Ho, Wc., Lam, P.Th., Chiu, T.Yh. et al. Comparison of central corneal thickness measurement by scanning slit topography, infrared, and ultrasound pachymetry in normal and post-LASIK eyes. Int Ophthalmol 40, 2913–2921 (2020). https://doi.org/10.1007/s10792-020-01475-5

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  • DOI: https://doi.org/10.1007/s10792-020-01475-5

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