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Accuracy of central and peripheral cornea thickness: a comparison of two clinically available instruments

Teodora Marinova, Vesela Ivancheva, Valeri Sheherov, Christina Grupcheva


Introduction : To compare the thickness measurements of central and peripheral cornea in healthy human subjects without eye symptomology, using laser scanning confocal microscopy (LSCM) and anterior segment OCT (AS-OCT), two technologies based on optical principle.

Materials and Methods : The study was based on evaluating repeatability and comparability of two different methods for measuring the corneal thickness in central and four peripheral corneal zones. Data were analyzed in two age groups, group A, 22±2 years (n= 27) and group B, 60±11 years (n=29). Fifty six subjects were clinically examined to observe corneal structure and confirm that there are no pathological changes. Each participant was then examined by AS-OCT and following topical anaesthesia by LSCM.

Results : The mean values of average central corneal thickness by anterior segment optical coherence tomography (AS-OCT) and Laser-scanning confocal microscopy (LSCM) in the group of younger individuals were 553.33±12.1 μm and 573.33±57.22 μm, respectively for the central cornea and 734.33±22.1 μm and 773.83±72.22 μm for corneal periphery. The group of aged participants presented results of CCT measured by AS-OCT and LSCM as follow: 561.12±19.1 μm and 593.93±60.72 μm, respectively for the central cornea and 742.33±30.1 μm and 789.31±78.92 μm for corneal periphery. LSCM demonstrated lower repeatability.

Conclusion : The study demonstrated that AS-OCT is better method for measurement of corneal thickness of subjects regardless their age. Furthermore the method is less invasive and provides thickness measurement of 70-80% of the corneal surface. The two methods should be combined to achieve comprehensive structural and morphological analysis of the human cornea in health and disease.


cornea; thickness; confocal microscopy; optical coherence tomography

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Ashwin PT, Shah S, Pushpoth S, Wehbeh L, Ilango B. The relationship of central corneal thickness (CCT) to thinnest central cornea (TCC) in healthy adults. ContLens Anterior Eye 2009;32:64-7.

Barkana Y, Y Gerber, U Elbaz, S Schwartz, Gie Ken-Dror, I Avni et al. Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry J Cataract Refract Surg - Vol 31 September 2005

Bourne WM, McLaren JW. Clinical responses of the corneal endothelium. Exp Eye Res 2004; 78:561-572

Buehl W, Stojanac D, Sacu S, Drexler W, Findl O. Comparison of three methods of measuring corneal thickness and anterior chamber depth. Am J Ophthalmol 2006; 141:7-12

Cairns G, McGhee CNJ. Orbscan computerized topography: attributes, applications, and limitations. J Cataract Refract Surg 2005; 31:205-220

Chakrabarti HS, Craig JP, Brahma A, Malik TY, McGhee CNJ.Comparison of corneal thickness measurements using ultrasound and Orbscan slitscanning topography in normal and post-LASIK eyes. J Cataract Refract Surg 2001; 27:1823-1828

Doughty MJ, Zaman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach. Surv Ophthalmol. 2000;44:367-408.

Geggel HS, Talley AR. Delayed onset keratectasia following laser in situ keratomileusis. J Cataract Refract Surg 1999; 25:582-586

Gherghel D, Hosking SL, Mantry S, Banerjee S, Naroo SA, Shah S. Corneal pachymetry in normal and keratoconic eyes: Orbscan II versus ultrasound. J Cataract Refract Surg 2004;30:1272-1277

Gordon MO, Beiser JA, Brandt JD, et al. The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:714-720.

Ho T., A. C. K. Cheng, S. K. Rao, S. Lau, C. K. S. Leung, and D. S. C. Lam, `Central corneal thickness measurements using Orbscan II, Visante, ultrasound, and Pentacam pachymetry after laser in situ keratomileusis for myopia,` Journal of Cataract and Refractive Surgery, vol. 33, No. 7, pp. 1177-1182, 2007.

Ilona Piotrowiak, Beata Soldanska,Mateusz Burduk, Bartlomiej J. Kaluzny, and Jozef Kaluzny, Measuring Corneal Thickness with SOCT, the Scheimpflug System, and Ultrasound Pachymetry, Ophthalmology Volume 2012, Article ID 869319, 5 pages

Iskander NG, Anderson Penn E, Peters NT, Gimbel HV, Ferensowicz M. Accuracy of Orbscan pachymetry measurements and DHG ultrasound pachymetry in primary laser in situ keratomileusis and LASIK enhancement procedures. J Cataract Refract Surg 2001; 27:681-685

Izatt JA, Hee MR, Swanson EA, et al. Micrometerscale resolution imaging of the anterior eye in vivo with optical coherence tomography. Arch Ophthalmol. 1994;112:1584-1589.

Jalbert I, F Stapleton, E Papas, D F Sweeney, M Coroneo, In vivo confocal microscopy of the human cornea Br J Ophthalmol 2003;87:225-236

Jalbert I, Papas E, Sweeney DF, et al. Instrument, diurnal, and day to day repeatability of in vivo measurements of the central human cornea using slit scanning confocal microscopy and modified optical pachometry. Invest Ophthalmol Vis Sci [ARVO abstract] 2002;43:68. (Abstract no 1713.)

Khoramnia R, Rabsilber TM, Auffarth GU. Central and peripheral pachymetry measurements according to age using the Pentacam rotating Scheimpflug camera. J Cataract Refract Surg 2007;33:830-6.

Kitsos G., C. Gartzios, I. Asproudis, and E. Bagli, `Central corneal thickness in subjects with glaucoma and in normal individuals (with or without pseudoexfoliation syndrome),` Clinical Ophthalmology, vol. 3, no. 1, pp. 537-542, 2009.

Lattimore MR Jr, Kaupp S, Schallhorn S, Lewis R IV. Orbscan pachymetry; implications of a repeated measures and diurnal variation analysis. Ophthalmology 1999; 106:977-981

Li HF, Petroll WM, Møller-Pedersen T, et al. Epithelial and corneal thickness measurements by in vivo confocal microscopy through focusing (CMTF). Curr Eye Res 1997;16:214-21.

Lili G, Yimin Y,Meixiao S, Aizhu T, Jianhua W and Fan Lu. The Role of Axial Resolution of Optical Coherence Tomography on the Measurement of Corneal and Epithelial Thicknesses, IOVS, January 2013, Vol. 54, No. 1

Medeiros F.A., P. A. Sample, and R. N. Weinreb, `Corneal thickness measurements and visual function abnormalities in ocular hypertensive patients,` American Journal of Ophthalmology, vol. 135, No. 2, pp. 131-137, 2003.

Miglior S., E. Albe, M. Guareschi, G. Mandelli, S. Gomarasca, and N. Orzalesi, Intraobserver and interobserver reproducibility in the evaluation of ultrasonic pachymetry measurements of central corneal thickness, British Journal of Ophthalmology, vol. 88, No. 2, pp. 174-177, 2004.

Muscat S, McKay N, Parks S, et al. Repeatability and reproducibility of corneal thickness measurements by optical coherence tomography. Invest Ophthalmol Vis Sci. 2002;43:1791-1795.

Shaheeda M., G. K. Y. Lee, S. K. Rao et al., Repeatability and reproducibility of pachymetric mapping with Visante Anterior Segment- Optical Coherence Tomography, Investigative Ophthalmology and Visual Science, vol. 48, No. 12, pp. 5499-5504, 2007.

Stave J, Slowik C, Somodi S, et al. Keratocyte density in the in vivo cornea. Automatic quantification with a modified confocal microscope MICROPHTHAL. Klin Monatsbl Augenheilkd 1998;213:38-44.

Taylor JR, An Introduction to Error Analysis: The Study of Uncertainties in Physical Measurements, University ScienceBooks, Sausalito, Calif, USA, 1999.

Usama F, Ahmad MO, Ali Al-Aqaba M, H. S. Dua. Correlation of central and peripheral corneal thickness in healthy corneas, Contact Lens & Anterior Eye 35 (2012) 39- 45

Vesaluoma M, Pérez-Santonja J, Petroll WM, et al. Corneal stromal changes induced by myopic LASIK. Invest Ophthalmol Vis Sci 2000;41:369-76.

Wheeler NC, Morantes CM, Kristensen RM, et al. Reliability coefficients of three corneal pachymeters. Am J Ophthalmol. 1992; 113:645-651.

Wong AC-M, Wong C-C, Yuen NS-Y, Hui S-P. Correlational study of central corneal thickness measurements on Hong Kong Chinese using optical coherence tomography, Orbscan and ultrasound pachymetry. Eye 2002; 16:715-721

Zheng Y, Huang G, Huang W, He M. Distribution of central and peripheral corneal thickness in Chinese children and adults: the Guangzhou twin eye study. Cornea 2008;27:776-81.



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About The Authors

Teodora Marinova
Medical University of Varna

Department of Ophthalmology and Visual Science

Vesela Ivancheva
Medical University of Varna

Department of Ophthalmology and Visual Science

Valeri Sheherov
Medical University of Varna

Department of Ophthalmology and Visual Science

Christina Grupcheva
Medical University of Varna

Department of Ophthalmology and Visual Science

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