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To evaluate the long-term visual, refractive, tomographic, and aberrometric outcomes of corneal collagen crosslinking (CXL) with or without hypoosmolar riboflavin solution in the treatment of progressive keratoconus patients with thin corneas. Charts of consecutive progressive keratoconus patients with thinnest corneal thickness less than 470 µm who underwent corneal collagen CXL with or without hypoosmolar riboflavin solution and using a standardized protocol for treatment and examinations were analyzed retrospectively. The indication for hypoosmolar riboflavin use was a central corneal thickness less than 400 µm as measured by ultrasound pachymetry after epithelial debridement and before exposure to ultraviolet A (UVA) light. Uncorrected distance visual acuity (UDVA), best spectacle-corrected distance visual acuity (CDVA), manifest refraction, slit lamp biomicroscopy, corneal tomography, corneal aberrometry, and endothelial cell counts were evaluated at baseline and yearly at all postoperative follow-up examinations until month 36. The outcomes of corneal CXL procedure performed using hypoosmolar riboflavin were compared to those performed using the standard procedure. Twenty-three eyes (19 patients) were treated using hypoosmolar riboflavin application, and 30 eyes (28 patients) were treated using the standard procedure. Compared to baseline, the mean UDVA, CDVA, and keratometric readings improved statistically significantly in both groups at postoperative year 3, without any statistically significant between-group differences. Progression was not observed in any patient eye in either group. No significant endothelial cell loss and no sight threating complication were observed in any patient eye. At 3 years follow-up, the safety and efficacy of CXL using hypoosmolar riboflavin solution seems to be similar to that of standard CXL in progressive keratoconic eyes with thin corneas. The visual, refractive, keratometric, tomographic and aberrometric outcomes of the two procedures were comparable, as well.

Aims: Evidence for choosing a satisfactory device for central corneal thickness (CCT) measurement in children particularly pseudophakic and aphakic ones is insufficient. The aim of this study is to compare four differently-measured CCTs obtained using ultrasound pachymetry (UP), Pentacam, partial coherence interferometry (PCI), and specular microscopy (SM) in phakic, pseudophakic, and aphakic children and assess the agreement between the six pairs of the methods. Methods: Children with history of cataract surgery at age six or younger and phakic children were recruited into this study. CCT was measured using UP (Optikon 2000, Rome, Italy), Pentacam (Oculus Inc, Wetzlar, Germany), PCI (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany), and SM (Topcon SP-3000P; Topcon Corporation, Japan).Results: One-hundred two eyes (53 phakic, 29 pseudophakic, and 20 aphakic eyes) were included. The mean ages (±SD) of phakic, pseudophakic, and aphakic cases were 9.75 (±3.3), 9.9 (±2.3), and 8.2 (±2.8) years respectively. The mean CCTs (±SE) for phakic children using Pentacam, PCI, UP, and SM were 549.7 (±5.0), 546.5 (±4.5), 565.9 (±5.5), and 506.2 (±4.4) mm respectively, for pseudophakic cases were 570.1 (±6.4), 565.0 (±6.1), 571.9 (±6.3), and 524.3 (±6.3) mm respectively, and for aphakic participants were 635.3 (±14.2), 635.4 (±14.5), 649.0 (±13.5), and 589.1 (±13.3) mm respectively. Conclusion: Compared to Pentacam and PCI, SM underestimated CCT particularly in phakic and pseudophakic children, whereas UP slightly overestimated CCT especially in phakic and aphakic children. Furthermore, Pentacam and PCI had the closest agreement. By contrast, SM had the poorest agreement with the other three methods.

Aim and objective To compare central corneal thickness (CCT) measurements obtained by handheld contact ultrasound pachymetry (HCUP) and non-contact pachymetry devices. Materials and methods Ninety eyes of 90 patients (52 male and 38 female) were included in the study. Measurements from two non-contact devices, —specular microscopy (SM, Konan Medical, CA, USA) and Oculus Pentacam (Oculus Inc., Germany)—were compared against HCUP (Pachmate 2, DGH Technology, Inc, PA, USA). Ultrasound measurements were obtained 3 times by the same user and averaged. The differences were calculated by one-way ANOVA. Agreement between measurements were assessed by Bland–Altman plots and intraclass correlation coefficient tests. Coefficient of repeatability (%, CR) was defined as 1.96*standard deviations of the differences between pairs of measurements divided by the average of the means. Results The mean age was 34.31 ± 14.39 (14–74) years, and the mean intraocular pressure was 16.48 ± 2.63 mm Hg (12–21). Mean CCT measured by HCUP, SM, and Pentacam was 557.76 ± 36.76 μm, 550.29 ± 43.74 μm, and 541.41 ± 35.7 μm, respectively (p < 0.05). In the Bland–Altman plot, 95% limit of agreements were 19.5 and 14.18 μm among HCUP measurements, 34.55 μm between HCUP and Pentacam, 41.49 μm between SM and Pentacam, and 46.98 μm between HCUP and SM. CR values (%) were 3.49, 2.54, 6.28, 7.68, and 8.47, respectively. Conclusion There were significant differences between the mean CCT values of the measurement devices. Clinical significance Contact and non-contact devices may not interchangeable in the clinical assessment of CCT. How to cite this article Mayali H, Altinisik M, Diri I, et al. Comparison of Central Corneal Thickness Measurements by Contact and Non-contact Pachymetry Devices. J Curr Glaucoma Pract 2021;15(1):28–31.

Purpose: We compared the accuracy of central corneal thickness (CCT) measurements according to CCT measured by noncontact Tono-pachymetry and ultrasound pachymetry (USP). Methods: CCT was measured in 90 eyes of 90 subjects by two optometrists. The CCT measurements were compared and the correlations between the measurements were analyzed. To evaluate whether the measurements varied depending on CCT, the subjects were classified into three groups according to CCT (group 1: thin thickness group; group 2: medium thickness group; and group 3: thick thickness group). The differences in CCT obtained by the two devices (△CCT = Tono-pachymetry-USP) were compared and analyzed among the three groups. Results: The average CCT measurements by Tono-pachymetry and USP were 523.26 ± 32.93 μm and 527.08 ± 37.33 μm, respectively. CCT by Tono-pachymetry was significantly thinner than by USP (△CCT= -3.82 ± 15.34, p = 0.020). The two measurements were strongly correlated (r = 0.912, p < 0.001). The △CCT values were 5.40 ± 12.13 μm in group 1, -6.37 ± 15.07 μm in group 2, and -10.50 ± 14.39 μm in group 3 (p < 0.001). Conclusions: CCT measured by tono-pachymetry was thinner on average compared to the value measured by USP and the differences in measurements between the two devices were different according to CCT. The thinner the CCT, the thicker the measurement, and the thicker the CCT, the thinner the measurement. Therefore, this trend should be considered when interpreting tono- pachymetry results in clinical practice.

Aims: To compare results of OrbscanIIz and Pentacam and Ultrasound pachymetry at different stages of keratoconus on corneal thickness. Sample and Study Design: 94 keratoconic patients participated in the study, of which 52 were men and 42 women. Keratoconus patients were measured with OrbscanIIz, Pentacam and Ultrasound pachymetry in pre-operation examinations for corneal collagen cross-linking. The patients belong to different keratoconus stages. Place and Duration of Study: University of West Attica Dept Biomedical Sciensce Course Optics & Optometry in collaboration with Athens “Ophthalmologico” Clinic during the period between October 2017 to January 2019. Methodology: Corneal Pachymetry maps correlation of three types of corneal pachymeters OrbscanIIz, Pentacam and Ultrasound pachymetry (Tomey SP-100 Pachymeter). The measurements of the thinnest point of the cornea from each patient were collected at different stages of keratoconus and compared. Results: A sample of 188 eyes were measured at different stages of keratoconus and compared for the thinnest corneal thickness with three different measurement systems, OrbscanIIz ,Pentacam and Ultrasound pachymetry. At sublinical stage Orbscan-Pentacam had Correlation coefficient r=0,7971, Orbscan-Ultrasound r=0,7483 and Pentacam-Ultrasound r=0,9442. At 1st stage Orbscan-Pentacam had Correlation coefficient r=0,8913, Orbscan-Ultrasound r=0,8151 and Pentacam-Ultrasound r=0,8151. At 2nd stage Orbscan-Pentacam had Correlation coefficient r=0,9339, Orbscan-Ultrasound r=0,8819 and Pentacam-Ultrasound r=0,9633. For 3rd stage Orbscan-Pentacam had Correlation coefficient r=0,8317, Orbscan-Ultrasound r=0,8457 and Pentacam-Ultrasound r=0,9633. For 4th stage Orbscan-Pentacam had Correlation coefficient r=-0,4655, Orbscan-Ultrasound r=0,3089 and Pentacam-Ultrasound r=0,9633. In Iatrogenic keratoectasiaafter refractive surgery Orbscan-Pentacam had Correlation coefficient r=0,9327, Orbscan-Ultrasound r=0,3089 and Pentacam-Ultrasound r=0,9859. Conclusion: Statistical differences between OrbscanIIz, Pentacam and Ultrasound pachymetry were found for corneal thickness in all stages of keratoconus for the thinnest point measured. Orbscan-Pentacam have statistical significant differences but weak to moderate correlation. Orbscan-Ultasound have also statistical significant differences their correlation is very weak, while Pentacam-Ultrasound have statistical significant differences smaller as the previous but their correlation is very strong at all stages of keratoconus.

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. 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. 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

PURPOSE To compare the central corneal thickness (CCT) measurements measured by using the Pentacam Scheimpflug system with the CCT measured using ultrasound pachymetry (UP) and to compare the compatibility between the methods in normal, keratoconic, and cross-linked keratoconic corneas. METHODS The study included 50 eyes of 50 patients with keratoconus (keratoconus group), 50 eyes of 50 patients with progressive keratoconus who underwent corneal cross-linking treatment (CCL group), and 50 eyes of 50 healthy subjects (control group). Patients in the keratoconus and CCL groups were further classified into mild (mean keratometry [Km] ≤ 47 D) and moderate keratoconus subgroups (47.0 < Km < 52.0 D). CCT values were noted from the Pentacam Scheimpflug and UP. RESULTS The difference between the Pentacam and UP values was largest in the CCL group (-20.9 0.21.5 μm), followed by the keratoconus and control groups (-10.6 0.20.3 and 0.4 0.6.8 μm). The Pentacam and UP measurements were not comparable in the keratoconus and CCL groups (P = 0.001 and P < 0.001), whereas they were comparable in the control group (P = 0.62). In subgroup analysis, the 2 methods were comparable in the mild keratoconus subgroup (P = 0.12) and not comparable in the moderate keratoconus subgroup and in both mild and moderate subgroups of the CCL group (P = 0.001, P < 0.001 and P < 0.001). CONCLUSIONS Pentacam Scheimpflug tomography and UP can be used interchangeably in normal and mild keratoconic eyes, but not in moderate keratoconic and cross-linked keratoconic eyes. Pachymetry measurements from Scheimpflug must be interpreted with extreme caution with different methods before planning an invasive procedure in these eyes.

To assess the agreement between Orbscan 3, Pentacam HR and ultrasound pachymetry (Palm Scan AP 2000) in measuring central corneal thickness. Prospective observational cross-sectional study of ninety-two eyes of 48 patients with normal corneas was conducted. Central corneal thickness was measured via Pentacam HR, Orbscan 3 and ultrasound pachymetry. Bland–Altman analysis was used to demonstrate agreement between various methods. Ninety-two eyes of 46 subjects were enrolled. The mean age was 29.67 years (18–59). The average measurements of central corneal thickness were 545.73 ± 29.35 μm, 549.34 ± 29.14 μm and 545.78 ± 31.48 μm for the Pentacam HR, Orbscan and ultrasound pachymetry, respectively. The three devices measurements are closely correlated, with Pearson correlation coefficient ranging from 0.868 to 0.929. The 95 % limits of agreement were 25.2 to − 18 μm between Orbscan and Pentacam central corneal thickness, 25.2 to − 25.7 μm between Pentacam and pachymetry central corneal thickness and 34.4 to − 27.2 μm between Orbscan and pachymetry central corneal thickness. In spite of advancement of Orbscan 3, still there are wide agreement limits between CCT measurements obtained via Orbscan 3, Pentacam HR and ultrasound pachymetry; thus, interchangeable use in clinical practice is not recommended.

Purpose: To compare corrected intraocular pressure (IOP) by tonopachy with that of Goldmann applanation tonometry (GAT) in normal and glaucomatous patients. Methods: In this cross-sectional study, IOP and central corneal thickness (CCT) were measured in 426 eyes (213 normal eyes and 213 glaucomatous eyes) of 426 patients by tonopachy followed by GAT and ultrasound pachymetry. IOP was corrected for CCT by in-built formula in tonopachy and Ehlers correction factor for Goldmann tonometer. Limits of agreements were assessed using Bland–Altman plots. Intraclass correlation coefficient was calculated to estimate the absolute agreement between single and average measurements of IOP and CCT of tonopachy with that of Goldmann tonometer and ultrasound pachymetry respectively. Results: Mean corrected IOP measured with tonopachy and GAT in glaucomatous eyes was 17.63 ± 5.04 mmHg and 19.42 ± 5.83 mmHg, and in controls it was 13.4 ± 2.5 mmHg and 16.2 ± 3.1 mmHg, respectively. Limits of agreement ranged from –4.63 to +9.25 mmHg for total population (mean = 2.31), ˗6.01 to +9.59 mmHg (mean = 1.79) for glaucoma group and ˗2.99 to +8.65 mmHg (mean = 2.83) for controls. Intraclass correlation coefficient for IOP measurement between tonopachy and Goldmann tonometer was 0.84 for total population, 0.85 for glaucoma group, and 0.63 for controls, respectively. Conclusion: Corrected IOP obtained by tonopachy showed moderate agreement with GAT and it is more in glaucoma patients than controls. Thus, tonopachy can be used as a screening tool, but cannot replace GAT.

The purpose of this study is to determine the influence of different degrees of corneal edema on the reliability and reproducibility of central corneal thickness(CCT) measurements by a Scheimpflug camera (Pentacam), anterior segment optical coherence tomography(AS-OCT) and ultrasound pachymetry(USP). Forty-four patients undergoing ophthalmic surgery were included in this prospective study. All measurements were acquired by two investigators. The Pentacam and AS-OCT measurements were performed in randomized order followed by USP. Two measurements were taken by each investigator with each device. CCT was evaluated by using the apex value provided by the Pentacam, the corneal apex cut in the AS-OCT and averaging 2 cycles of 4 measurements for USP. Coefficients of variation (COV) and intraclass correlation coefficients (ICC) were determined. To investigate the reproducibility in different degrees of corneal edema, patients were subdivided into edema more/less than 10% of CCT, ≥/ 650 μm CCT. No significant differences were recorded for each individual investigator and measuring device. However, overall the devices differed significantly in the < 600 μm group (ANOVA p < 0.04). The reproducibility decreased with higher degrees of corneal edema in particular for investigator 1 and USP measurements. No significant overestimation of corneal thickness by the Pentacam was recorded in higher degrees of corneal edema. USP measurements are highly user dependent especially in higher degrees of corneal edema. Nevertheless, all methods were able to reach a high level of agreement in CCT measurement in higher degrees of corneal edema. Interestingly lower degrees of corneal edema revealed the only significant differences in-between the 3 devices.

Purpose: To determine the mean difference in central corneal thickness between ultrasound pachymetry and anterior segment optical coherence tomography in patients visiting tertiary care hospital of Karachi Study design: Cross sectional study Place and Duration of Study: Department of Ophthalmology, Liaquat National Hospital, Karachi from 27th December 2018 to 26th June 2019. Methods: Total 216 eyes of 108 patients were divided into two groups. Central corneal thickness was measured using ultrasound pachymeters in group A and with anterior segment optical coherence tomography in group B. Data was collected and analyzed using SPSS version 21. Mean central corneal thickness was compared between the two methods. Stratification was done on gender, age and post-stratification independent sample t-test was applied for mean difference CCT and P-value ≤ 0.05 was taken as significant. Results: Total 108 patients were equally divided into two groups. Mean age was 48.70±7.82 years in group A and 50.66±6.88 years in group B. In group A, there were 74.1% males and 25.9% females while in group B, there were 75.9% males and 24.1% females. There was statistically significant difference between the mean central corneal thickness of group A and group B for right and left eyes (p 45 years). Conclusion: Central corneal thickness was more with pachymeters as compared to the AS-OCT (p value < 0.05) Key Words: Central Corneal Thickness, Anterior Segment Optical Coherence Tomography, Ultrasound Pachymetry.

Aim: To study the correlation between type 2 diabetes mellitus and central corneal thickness in patients coming to the outpatient department of Dr. B.R. Ambedkar Medical College and Hospital. Materials and Methods: This prospective case control study was conducted over a period of 1 year from June 2018 to June 2019 at DR. B. R. Ambedkar Medical College and Hospital, Bangalore. A total of 120 patients were enrolled in the study. Among them, 60 patients had type 2 diabetes mellitus and 60 patients were non diabetics. Detailed ophthalmic examination was conducted in all patients and Central corneal thickness was measured using ultrasound pachymetry. Results: In our study, 120 patients were enrolled including 60 diabetics and 60 non diabetics. The mean central corneal thickness in diabetics was 56722m and in non diabetics it was 520 23m. The difference between cases and control group was found to be clinically significant. Conclusion: According to our study, the patients with type 2 diabetes mellitus were found to have thicker corneas as compared to non diabetics. Keywords: Type 2 diabetes mellitus, Central corneal thickness, Ultrasound pachymetry.

To compare the measurement of central thickness and depth of involvement of opacity-bearing corneas at different intensities (mild, moderate, and dense) using different instruments: Visante and Optovue OCTs, ultrasound biomicroscopy (UBM), and ultrasound pachymetry (central thickness). Sample of 102 eyes: 70 eyes (68.63 %) with corneal opacity; 32 eyes (31.37%) with normal corneas. Corneal opacity grading included mild (28 eyes, 40.00 %), moderate (27 eyes, 37.57 %), and dense (15 eyes, 21.43 %). Opacity intensity was graded and documented. Central corneal thickness was determined using Optovue and Visante OCTs, ultrasound pachymetry, and UBM VuMax (50 MHz), and depth of corneal opacity, using Optovue and Visante OCTs and UBM. Total corneal thickness of the control group showed differences with a small correction factor using Optovue OCT (534.03 ± 39.88 μm), Visante OCT (523.72±38.70 μm), and ultrasound pachymetry (529.84 ± 39.76 μm), and were higher when compared to UBM (492.06 ± 37.93 μm). In mild opacity, depth measurements were the same with OCT Optovue and Visante and higher than those by UBM. In moderate opacities, there were no differences in measurements by different instruments. In dense opacities, OCT Optovue and Visante measurements were the same and higher than those by UBM. Central corneal thickness measurements were considered higher in corneas with opacity than in normal corneas. We observed that the greatest thicknesses were measured in corneas with dense opacities. There was a difference between the measurements taken by different instruments, both in central thickness and in opacity depth in cases of mild and dense opacity, and no difference in moderate opacity.

We retrospectively compared the central corneal thickness (CCT) obtained by ultrasound pachymetry (USP; SP-3000, Tomey Corp., Nagoya, Japan), non-contact tonopachy (TP) (NT-530P, Nidek Co., Ltd., Gamagori, Japan), Pentacam HR (OCULUS Inc., Wetzlar, Germany), and RTVue optical coherence tomography (OCT) (Optovue Inc., Fremont, CA, USA) in 78 eyes of 78 healthy subjects with myopia. Agreement between the measurement methods was evaluated using 95% confidence intervals for the limits of agreement (LoA). The mean CCT values were 546.9 ± 34.7, 548.1 ± 33.5, 559.2 ± 34.0, and 547.2 ± 34.8 μm for USP, non-contact TP, Pentacam, and RTVue, respectively. The thickest and the thinnest mean CCT values corresponded to those obtained by Pentacam HR and USP, respectively. Plots of the differences against the means showed the best agreement between USP and RTVue (LoA, 10.14-10.70 μm), while the largest discrepancy was observed between RTVue and Pentacam systems (LoA, -25.47-1.44 μm). Our data showed that CCT measurements using these 4 instruments were well correlated. However, the results from Pentacam differed significantly from those of the other instruments.

PURPOSE: To describe a new surgical technique where corneal cross-linking (CXL) (to treat corneal ectasias) and photo-activated chromophore for keratitis-CXL (PACK-CXL) are performed while the patient is seated in an upright position at the slit lamp. METHODS: Topical anesthesia is applied in the waiting room, 10 minutes before the procedure. Once in the office or procedure room, eyelids and periorbital areas are disinfected with chloramphenicol and the patient is seated at the slit lamp. Epithelial debridement is performed with a cotton swab soaked in freshly prepared 40% ethanol, using 70 seconds of tapping, followed by gentle pressure to remove the epithelium. The patient is placed in the supine position for riboflavin application for 10 minutes. Stromal thickness is assessed using ultrasound pachymetry after 5 and 10 minutes. Finally, the patient is returned to the slit lamp to receive ultraviolet irradiation. RESULTS: CXL at the slit lamp is an easy-to-perform technique that substantially reduces the infrastructure needed to perform CXL and PACK-CXL procedures. CONCLUSIONS: A significant advantage of allowing CXL treatment at the slit lamp is that CXL technology can now be used in clinics that do not have easy access to an operating room infrastructure. Slit-lamp CXL can also reduce procedure costs by eliminating the technical fees related to the use of an operating room, making this treatment not only more accessible for patients, but also affordable. [ J Refract Surg . 2021;37(2):78–82.]

BackgroundTo compare the difference in central corneal thickness (CCT) measurements in normal eyes between a rotating Scheimpflug camera combined with a Placido-disk corneal topographer (Sirius, CSO, Italy) and ultrasound pachymetry (USP).MethodsA systematic literature search was conducted for relevant studies published on PubMed, Medline, EMBASE, and the Cochrane Library and ClinicalTrials.gov from inception to August 1st, 2019. Primary outcome measures were CCT measurements between Sirius and USP. A random effects model was used to pool CCT measurements.ResultsA total of twelve studies involving 862 eyes were included in this meta-analysis. The meta-analysis found CCT measurements between Sirius and USP to be statistically significantly different (P 2 = 60% (P = 0.004).ConclusionCCT measurements with the Sirius Scheimpflug-Placido topographer were statistically significantly lower than USP. However, it may be argued that the mean difference of 11.26 μm is not a clinically significant difference.

PurposeTo evaluate the agreement of central corneal thickness (CCT) measurement between Scheimpflug imaging and ultrasound (U/S) pachymetry in keratoconic eyes, and investigate factors that affect the agreement.MethodsThis post hoc analysis within a prospective, observational non-randomised study preformed at the Kensington Eye Institute, Toronto, Ontario, Canada, included crosslinking candidates with progressive keratoconus (KC). Main outcome measures were the agreement of CCT measurement between Scheimpflug imaging (Pentacam Oculus, Wetzlar, Germany) and U/S pachymetry (PachPen 24–5100, Accutome Inc., Malvern, Pennsylvania, USA), and factors that affect the agreement.ResultsA total of 794 keratoconic eyes of 456 subjects with a mean age of 27.6±8.0 years (69.7% males and 49.6% right eyes) were included. Agreement between devices was moderate (intraclass correlation coefficient: 74.9%, Bland–Altman limits of agreement: −48.5 μm to +62.5 μm). In a multivariable analysis, cone decentration (pConclusionThe agreement of CCT measurement between Scheimpflug imaging and U/S pachymetry in KC was moderate. To ensure the safety of crosslinking in keratoconic corneas, Scheimpflug and U/S CCT measurements should not be used interchangeably, especially in steep corneas and corneas with decentred cones.

Background: Corneal thickness (CT) is an important parameter in refractive surgery but available data is scanty on corneal thickness of normal Malays. The purpose of this study is to determine central and peripheral CT in a sample of Malays and find its effect on age.Methods: Seventy–two (72) participants were invited to participate in this study. Their age ranged from 15 to 65 years old. CT was measured using an ultrasonic pachometer (Corneo-Gage TM Plus2) at 5 different locations namely central, superior, temporal, inferior and nasal regions of the cornea. A total of three readings were taken for each location of the cornea and the mean was calculated. CT was presented as total, epithelial and stromal thickness for three age groups, namely 40 years for comparison.Results: Mean value for central CT for Malays was 597.9 ± 35.2 μm and peripheral CT was significantly thicker than the centre at all locations. There was significant thinning in CT as age advanced at all locations except at the centre. The epithelial layers do not show any changes with respect to location and age which implied that changes in CT at different location and as results of advancing age were mainly due to the stroma.Conclusion: The values of CT in normal Malays was 597.9 ± 35.2 μm and CT was thinnest at the central region. Except at the central region CT decreased with advancing age. These values can be a suitable reference when planning for refractive surgery and penetrating keratoplasty among Malays.Bangladesh Journal of Medical Science Vol.17(4) 2018 p.600-605

Nida Wongchaisuwat,1,2 Ankana Metheetrairat,1 Pratuangsri Chonpimai,1 Waree Nujoi,1 Pinnita Prabhasawat1 1Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Department of Ophthalmology, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand Purpose: To compare the central corneal thickness (CCT) measurements in subjects with corneal edema using ultrasound pachymetry, Visante anterior-segment optical coherence tomography (OCT), Cirrus OCT, and Pentacam Scheimpflug camera tomography.Methods: This prospective cross-sectional study included 46 eyes of 33 patients with corneal edema and a CCT exceeding 550 μm evaluated by ultrasound pachymetry, Visante OCT, Cirrus OCT, and Pentacam. Two observers measured each eye twice. Intraobserver and interobserver reproducibility were determined and agreement among the devices calculated.Results: CCT was measured in 40 eyes of 29 patients. Regardless of the CCT, the measurements obtained using Visante OCT, Cirrus CCT, and ultrasound pachymetry were well correlated. Interobserver and intraobserver reproducibility were high among the three devices. Pentacam overestimated the results compared with the other devices, and ultrasound pachymetry was unmeasurable in six (13%) eyes with very thick and opaque corneas. In eyes with mild corneal edema (CCT 551–650 μm), measurements from the four devices were comparable.Conclusion: All devices reliably measured the CCT

There is currently little evidence assessing the repeatability and accuracy of central corneal thickness measurements using the devices Tonoref III and RS-3000. This study aims to compare these devices against measurements by ultrasound pachymetry. Central corneal thicknesses were measured on 50 eyes. Measurements from two non-contact devices—Tonoref III (NIDEK CO., LTD, Gamagori, Japan) and RS-3000 (NIDEK CO., LTD, Gamagori, Japan)—were compared against ultrasound pachymetry, the gold standard. Ultrasound measurements were obtained using a ‘Pachmate’ device (DGH Technology, Inc, Exton, PA, USA). Repeatability was defined as the value that the difference between two consecutive measurements falls below 95% of the time. The within-subject standard deviation and repeatability values were calculated for Pachmate and Tonoref III by one-way ANOVA. Repeatability of RS-3000 was determined by nonparametric analysis. Agreement between Tonoref III and Pachmate was assessed by a Bland–Altman plot. Agreement between RS-3000 and Pachmate was assessed by nonparametric analysis. The Pachmate, Tonoref III and RS-3000 had repeatability values of 16, 7.4 and 5 µm, respectively. The mean difference between Tonoref III and Pachmate was − 15 µm (95% LoAs − 31 to + 0 µm). The median value for the difference between RS-3000 and Pachmate was − 4 µm (95% of values within − 24 and + 4 µm). The Tonoref III and RS-3000 showed good repeatability when compared to ultrasound pachymetry. However, neither instrument agreed interchangeably with CCT measurements by ultrasound pachymetry. Practitioners should determine whether the level of agreement is sufficient to meet their clinical needs.

BACKGROUND To compare intraocular pressure (IOP) measurements obtained with the Topcon CT-80 non-contact tonometer (NCT) and Goldmann applanation tonometer (GAT), in different ranges of IOP in normal and glaucoma subjects, and to assess the influence of central corneal thickness (CCT) on the IOP measurements in Asian Indian eyes. METHODS Four hundred and two eyes of 402 subjects (193 newly diagnosed primary open angle glaucoma [POAG] and 209 normal) were enrolled for this prospective study. For each eye, IOP was measured with GAT by a glaucoma specialist and NCT by a trained optometrist. The IOP values were compared among the tonometers in the three different IOP ranges (≤ 12 mmHg, 13-20 mmHg and ≥ 21 mmHg) using Bland-Altman graphs. Correlation between GAT and NCT was assessed by Pearson correlation co-efficient. CCT was measured with ultrasound pachymetry and its correlation with GAT and NCT was analysed using linear regression analysis. RESULTS The mean paired difference of IOP between NCT and GAT was 1.556 ± 2.69 mmHg (r = 0.26, p = 0.006) at IOP range of ≤ 12 mmHg, -1.665 ± 2.6 mmHg (r = 0.51, p < 0.0001) in IOP range of 13-20 mmHg and -2.202 ± 3.44 mmHg (r = 0.82, p < 0.0001) in the IOP range of ≥ 21 mmHg. Linear regression analysis showed a mean IOP variation of 0.27 mmHg per 10 μm change in CCT for NCT (p < 0.0001) and IOP change of 0.19 mmHg per 10 μm change in CCT for GAT (p = 0.01). CONCLUSION In this study of normotensive and POAG subjects, the Topcon CT-80 NCT showed an overestimation of IOP at the lower range and underestimation of IOP in normal and higher ranges of IOP. Clinicians should keep in mind that CCT influences IOP measurement with both types of tonometer and that the IOP readings obtained with these tonometers are not interchangeable.

To investigate the effects of uneventful phacoemulsification on central corneal thickness (CCT) and corneal volume (CV) in pseudoexfoliative eyes during a 3 months postoperative period and compare these changes to eyes without pseudoexfoliation (PEX) syndrome. Another purpose of this study was to compare the CCT measurements done by ultrasound pachymetry (UP) with those done by the Oculus Pentacam. A total of 42 eyes of 42 consecutive patients with cataracts and PEX syndrome that underwent uneventful phacoemulsification were enrolled in this prospective study. A control group of 42 eyes of 42 patients with cataracts/without PEX was employed for comparison. CV and CCT measurements were obtained preoperatively and at 1 and 3 months postoperatively with the Pentacam. CCT values were also measured with UP. T test and Wilcoxon sign test were used to compare the variables. The mean age of the patients was 72.1 ± 8.3 and 66.6 ± 9.6 years in PEX and non-PEX group, respectively. In both groups, there were no significant differences between preoperative and postoperative CV (Fig. 1), CCT by the Pentacam (Fig. 2) and CCT by UP (Fig. 3) values (p > 0.05). CCT measurements obtained by two devices were also similar, and there were no statistically significant differences (p > 0.05). Changes in CV and CCT remained stabile at 3 months postoperatively. Eyes with and without PEX syndrome exhibit similar corneal features before and after phacoemulsification. A surgery in early stages of cataracts in PEX syndrome, not only provides a non-complicated surgery, but also leads to a less damaged cornea similar to eyes without PEX.

Objective To evaluate the clinical efficacy among ultrasound pachymetry (UP), ultrasound biomicroscopy (UBM), and manual measurement (MM) with digital caliper by comparing corneal thickness (COT) values obtained from frozen canine corneas ex vivo. Procedures COT was measured using UP, UBM, and MM in eight enucleated normal canine eyes frozen at −20 °C for 4 weeks. After thawing at room temperature for 2 h, the COT values were obtained from five sites on each cornea: central corneal thickness (CCOT), thickness at the 3, 6, 9, and 12 o'clock positions (3COT, 6COT, 9COT, and 12COT, respectively). For each device, measurements were performed three times at each designated site by one operator. Intraclass correlation coefficient, repeated-measures analysis of variance, and Bland–Altman plot were performed for statistical analyses. Results The mean CCOT was 839.0 ± 138.2, 857.6 ± 127.9, and 849.1 ± 132.8 μm for UP, UBM, and MM, respectively. There was no statistically significant difference among the measurements by all three devices (P > 0.05). The statistical agreement among these devices was also shown to be good according to Bland–Altman plots. In addition, the values measured on the peripheral sites of the cornea (3COT, 6COT, 9COT, and 12COT) also revealed no significant differences among the three devices. The difference between CCOT and peripheral corneal thickness was also statistically insignificant. Conclusions The UP, UBM, and MM measurements showed statistically similar COT values. The UBM and UP provided accurate and reliable measurements comparable to MM and could be used effectively for clinical COT measurements.

Purpose: To compare and analyze the interchangeability of three measuring systems, each based on a different technique, for central corneal thickness (CCT) analysis. Methods: CCT measurements were measured using optical coherence tomography (OCT), non-contact specular microscopy (NCSM), and ultrasonic pachymetry (USP) in 60 eyes of 60 healthy patients with a mean age of 66.5 ± 15.0 years and a mean spherical equivalent of 0.43 ± 1.14 D. Analysis of variations in measurement concordance and correlation among the three different methods were performed. Comparison of CCT measurements were done using Bland–Altman plots (with bias and 95% confidence intervals), intraclass correlation coefficient (ICC), and paired t-student analysis. Results: Mean CCT values were: 549.20 ± 26.91 μm for USP (range 503–618 μm), 514.20 ± 27.49 μm for NCSM (range 456–586 μm) and 542.80 ± 25.56 μm for OCT (range 486–605 μm). CCT values obtained with NCMS were significantly lower than those obtained with OCT and USP methods. NCMS CCT value was 36.08 ± 10.72 μm lower than USP value (p

Author(s): Oatts, Julius T; Keenan, Jeremy D; Mannis, Tova; Lietman, Tom M; Rose-Nussbaumer, Jennifer | Abstract: PurposeTo assess the relationship between corneal thinning measured by clinician-graded slit-lamp examination compared with ultrasound pachymetry (USP), anterior segment optical coherence tomography (AS-OCT), and the Pentacam.MethodsPatients with corneal thinning underwent USP, AS-OCT, Pentacam measurements and standardized clinical grading by 2 cornea specialists estimating thinning on slit-lamp examination. Reproducibility of each testing modality was assessed using the intraclass correlation coefficient. Bland-Altman plots were used to determine precision and limits of agreement (LOA) between imaging modalities and clinical grading.ResultsWe included 22 patients with corneal thinning secondary to infectious or inflammatory keratitis. Mean percent stromal thinning estimated by grader 1 was 51% (SD 31) and grader 2 was 49% (SD 33). The intraclass correlation coefficient between the masked examiners was 0.95 (95% confidence interval, 0.88-0.98). Graders were more similar to each other than to any other modality with 2% difference and 4.6% of measurements outside the LOA. When measuring the area of maximum thinning, AS-OCT measured approximately 10% thicker than human graders while the Pentacam measured approximately 10% thinner than human graders with 16.7% outside the LOA. USP measured approximately 20% thinner than human graders with 5.6% outside the LOA.ConclusionsTrained corneal specialists have a high degree of agreement in location and degree of corneal thinning when measured in a standardized fashion on the same day. Other testing modalities had acceptable reproducibility and agreement with clinical examination and each other, although Scheimpflug imaging fared worse for corneal thinning, particularly in the periphery, than the other modalities.

This study was conducted to analyze the profile and thickness of endothelial keratoplasty lenticules prepared from fresh donated whole eyes with Visante optical coherence tomography (V-OCT) compared to measurements obtained from ultrasound pachymetry (USP) at the Central Eye Bank of Iran. Microkeratome-assisted precut corneas were prepared for Descemet stripping automated endothelial keratoplasty by using standard eye bank protocol. Central posterior lenticule thickness (CPLT) on fresh whole eye, before excising corneoscleral disc and transferring to Optisol-GS, was measured by USP. V-OCT was used to measure central, paracentral, and midperipheral thicknesses of lenticules after transferring the tissue to Optisol-GS. Chi Square and Bonferroni tests were respectively used to uncover the differences between the USP and V-OCT measurements and also the thickness profile of lenticules. Postoperative reports for the entire transplanted lenticules were recorded. Accordingly, on evaluation of 312 enrolled precut corneas, CPLT measurements by V-OCT versus USP were statistically different (mean: 136 µm vs 165 µm, respectively; P = 0.008). Thickness profile of the posterior lenticules revealed increased thickness from the central to the peripheral parts of the cornea (mean increase of 16 µm at the pericentral and 64.2 µm at the peripheral locations, respectively); however, the increase in the thickness was relatively symmetrical. Postoperative reports of transplanted lenticules were unremarkable, since there were no posterior flap detachments. In essence, V-OCT measurements of microkeratome-assisted precut lenticules prepared from fresh donated whole eyes averaged 29 μm thinner than USP measurements and revealed a significant but symmetric increase of thickness towards the peripheral parts of the corneas. However, the variation in the thickness profile did not affect the attachment or the clarity of transplanted precut lenticlues.

WOS: 000462476400011 PubMed: 30900581 To compare central corneal thickness (CCT) measurements obtained by the AL-Scan, Lenstar LS900, Galilei, and ultrasound pachymetry (UP) in normal and cataractous eyes. Methods: Eighty eyes of healthy subjects were included in the study. Each subject was assessed by four different methods of measurements using the AL-Scan, Lenstar LS900, Galilei, and UP by a single examiner. To assess the intraobserver repeatability, three consecutive measurements were taken for the AL-Scan. Results: The mean CCT [+/- standard deviation (SD)] for the AL-Scan, Lenstar LS900, Galilei, and UP were 554.6 +/- 30.9 mu m, 542.9 +/- 31.3 mu m, 570.7 +/- 30 mu m, and 552.7 +/- 32.8 mu m, respectively. The differences between pairs of mean CCT for the methods are statistically significant for the pairs of Galilei-UP, AL-Scan-Galilei, and Lenstar LS900-Galilei. Bland-Altman plots showed that AL-Scan-UP have the closest agreement, followed by Lenstar-UP and AL-Scan-Lenstar. Galilei was found to have the poorest agreement with the other three methods. The intraobserver repeatability of the AL-Scan was very good with an intraclass correlation coefficient (ICC) of 0.980. Conclusion: We found that CCT measurements between the AL-Scan-UP, Lenstar LS900-UP, and AL-Scan-Lenstar LS900 showed very strong correlation and comparable agreement. AL-Scan-UP showed the closest agreement and these devices can be used interchangeably in clinical practice. Galilei significantly showed higher value of CCT compared to other methods. It was also observed that the Al-Scan had excellent intraobserver repeatability.

Purpose: To determine the mean difference of central corneal thickness measurements by using ultrasound Pachymetry and oculus Wave light Occulyzer II. Study Design: Cross-sectional comparative study using non-probability consecutive sampling. Place and Duration of Study: This study was conducted at Department of Ophthalmology, Liaquat National Hospital Karachi from November 2018 to June 2019. Material & Methods: After approval from ethical committee, patients were included in our study on the basis of inclusion & exclusion criteria. Central corneal thickness measurements were taken by using ultrasound Pachymetry & oculus Wave light Occulyzer II. All the data was collected by single researcher. The results were plotted, compared & analyzed. Paired t-test was used for the comparison of quantitative variables. Results: There were 130 patients included in the study out of which 73 (56.2%) were males and 57 (43.8%) were females. Mean age of these patients was 33.9 � 8.9 years. The mean � SD thinnest oculus Wave light Occulyzer II measurement was 538.61 � 23.46 ?m and ranged between 476.0 and 619.0 ?m whereas the mean thinnest ultrasound Pachymetry measurement was 535.1 � 21.816 ?m and ranged between 482 and 601 ?m. There was highly significant correlation of central corneal thickness between both the instruments. (r = 0.96, p < 0.001). Conclusion: There is a high correlation of central corneal thickness between the readings obtained from ultrasound and optical pachymetry machines therefore oculus Wave light Occulyzer II can be used as an alternative technique to ultrasound pachymetry while assessing CCT in clinical settings. Key Words: Central corneal thickness, Ultrasound Pachymetry, Optical Pachymetry.

PReCIS:: Optical and ultrasound pachymetry cannot be used interchangeably in young, healthy adults. In elderly, healthy and glaucoma patients the speed of ultrasound in the cornea increases because of changing corneal biomechanical characteristics in age and disease and the different devices could be used interchangeably. PURPOSE The purpose of this study was to compare central corneal thickness (CCT) using optical and ultrasound pachymetry in patients with open-angle glaucoma and young as well as elderly, healthy controls. Further to investigate whether the devices could be used interchangeably. METHODS In total, 69 eyes of 41 glaucoma patients, 51 eyes of 32 elderly and 50 eyes of 25 young controls were consecutively included in this cross-sectional observational study. Optical CCT measurements were obtained using the noncontact Specular Microscope CEM-530 (NCSM). Ultrasound pachymetry (USP) was measured using the Pachy Meter SP 3000. RESULTS In young subjects (27.2±4.8 y), the mean CCT taken with NCSM and USP was 562.1±33.6 μm and 565.8±35.8 μm, respectively. This was significantly different (USP>NCSM, P=0.019). In elderly subjects (70.6±10.7 y) CCT measured with NCSM (562.5±27.8 μm) compared to USP (564.9±27.1 μm) was not statistically significantly different (P= 0.121). In glaucoma patients (65.0±11.1 y), USP measured thinner CCT values compared to NCSM, without significant differences between the devices (NCSM 525.3±32.3 μm; USP 522.9±33.15 μm; P=0.067). CCT was significantly thinner in comparison to both healthy groups (P< 0.001). CONCLUSIONS In young subjects, ultrasound pachymetry measurements are higher than they are with optical pachymetry. This difference is no longer observed in elderly subjects and is even reversed in glaucoma patients. A higher speed of ultrasound in the cornea due to changing corneal biomechanical properties in the elderly and glaucoma patients could explain this. The devices could be used interchangeably in older and glaucoma patients, but not in young individuals.

Purpose The aim of the study was to assess the accuracy of optical coherence tomography (OCT) (3D OCT-2000) in diagnosing keratoconus by measuring the central corneal thickness and the central curvature radius. Patients and methods In this observational study, 50 patients with keratoconus underwent corneal topography, ultrasound pachymetry, Scheimpflug imaging, and anterior-segment optical coherence tomography (AS-OCT). Results The mean corneal power measured by AS-OCT was 51.65 ± 0.78 D, that measured with corneal topography was 50.19 ± 0.64 D, and that with the Sirius Scheimpflug camera was 50.78 ± 0.82 D. The mean central corneal thickness measured by OCT was 486 ± 73 μm, that measured by ultrasound was 475 ± 49 μm, and that using the Sirius Scheimpflug camera was 481 ± 66 μm. Conclusion 3D OCT-2000 may be a useful alternative for measuring the anterior corneal power and the central corneal thickness in keratoconic eyes.

Purpose: To compare central corneal thickness (CCT) measured by standard ultrasound pachymetry (USP), and three non-contact devices in healthy eyes. Methods: A cross-sectional study of CCT measurement in 52 eyes of 52 healthy volunteers was done by a single examiner at Ocular Surface and Contact Lens Laboratory. Three consecutive measurements were done by standard USP, non-contact tono-pachymeter, Pentacam corneal topographer, and Anterior Segment Optical Coherence Tomography (AS-OCT). The mean values were used for assessment. The results were compared using multivariate ANOVA, linear regression, and Pearson correlation. Agreement among the devices was analyzed using mean differences and Bland–Altman analysis with 95% limits of agreement (LoA). Finally, reliability was analyzed using intraclass correlation coefficient (ICC). Results: Mean CCT by ultrasound pachymeter, tono-pachymeter, corneal topographer and AS-OCT were 558.9 ± 31.2 µm, 525.8 ± 43.1 µm, 550.4 ± 30.5 µm, and 545.9 ± 30.5 µm respectively. There was a significant positive correlation between AS-OCT and USP (Pearson correlation = 0.957, p < 0.001), corneal topography and USP (Pearson correlation = 0.965, p < 0.001), and corneal topography and AS-OCT (Pearson correlation = 0.965, p < 0.001). There was a lower correlation between CT-1P tono-pachymeter and the other three modalities. Intraclass correlation coefficients show an excellent reliability between pairs except for CT-1P against the other three instruments that were found moderate. Conclusions: CT-1P tono-pachymeter underestimates CCT measurements compared to Scheimpflug system, AS-OCT device, and USP. Mean CCT among USP, Pentacam and AS-OCT were comparable and had significant linear correlations. In clinical practice, these three modalities could be interchangeable in healthy patients, info:eu-repo/semantics/publishedVersion

Purpose: to compare the rebound tonometer ICare® (RT) with the Goldmann applanation tonometer (GAT) in cataract surgery and to assess the influence of central corneal thickness (CCT) on intraocular pressure (IOP) measurements. Design: retrospective, comparative study. Methods: a total of 472 patients underwent IOP measurement using RT (time 0 = RTa). GAT IOP measurement was performed 5 minutes later, followed by a second RT IOP measurement after other 5 minutes (RTa + 10 min = RTb). CCT was obtained by ultrasound pachymetry. In 106 patients IOP was measured by means of RT and GAT before clear corneal cataract surgery (RT1 and GAT1) and at one day postoperatively (RT2 and GAT2). Results: RT IOP values > 5 mmHg were overestimated, while RT IOP values < 15 mmHg were underestimated. Every 100 µm of CCT an increase of 0.97 mmHg and 0.33 mmHg was found for RT and GAT respectively. The difference between RT1 and RT2, GAT1 and GAT2, RT1 and GAT1 was not statistically significant; while the difference between RT2 and GAT2 was statistically significant (p < 0.04). The difference between RTa and RTb was not statistically significant whereas the difference between RTa and GAT and RTb and GAT was statistically significant (p < 0.001). Conclusion: our results showed a good agreement between measurements obtained with RT and GAT in pre and postoperative cataract surgery, although a significant statistically difference was found between RT and GAT measurements performed postoperatively. Moreover, CCT is a parameter to be considered for the IOP measurement, especially for values obtained with RT.

WOS: 000444817100007 PubMed ID: 29509052 Background: To determine the agreement of central corneal thickness (CCT) measurements taken with ultrasonic pachymetry (USP), spectral domain optical coherence tomography (SD-OCT) and noncontact specular microscopy (NSM). Methods: A prospective, observational, cross-sectional study was performed in the outpatient ophthalmology clinic. CCT was measured in a total of 147 eyes of 147 consecutive healthy patients with USP, NSM, and SD-OCT. Same examiner performed all examinations. Bland-Altman plots were used to evaluate the agreement between instruments. Results: The average CCT values obtained by USP, NSM, and SD-OCT were 555 +/- 37 mu m, 554 +/- 34 mu m, and 546 +/- 34 mu m, respectively. There was a strong correlation between instruments: USP with SD-OCT (r = 0.937, p

ResumenObjetivoComparar los valores de grosor corneal central obtenidos mediante el tomógrafo de cámara de Scheimpflug con anillos de plácido (Sirius®), y la paquimetría ultrasónica; y conocer la repetibilidad intraobservador de ambos equipos.Material y métodosSe realizaron estudios de grosor corneal central con ambos equipos en 30 personas sanas. Para evaluar la repetibilidad, se realizaron 3 mediciones para cada individuo con cada equipo y se evaluó el coeficiente de variación, la desviación estándar y el coeficiente de correlación intraclase. Para conocer la concordancia entre ambos equipos, se calculó la diferencia de medias con la t de Student pareada y se realizaron gráficas de Bland y Altman.ResultadosPara el equipo Sirius®, el coeficiente de variación fue del 0.291% y para el paquímetro ultrasónico del 0.238%. La desviación estándar fue 0.123μm y 0.101μm para el Sirius® y el paquímetro ultrasónico respectivamente, y el coeficiente de correlación intraclase fue mayor de 0.95 en todas las mediciones. El paquímetro ultrasónico midió sistemáticamente valores más altos y estadísticamente significativos que el Sirius® (media 543.867 vs. 558.267μm, Sirius® y paquímetro ultrasónico respectivamente), sin embargo, esta diferencia no es clínicamente significativa.ConclusionesEn la evaluación de córneas normales, la medición del grosor corneal central con ambos equipos mostró una alta repetibilidad y adecuada concordancia. Aunque la medición del grosor corneal central fue sistemáticamente más baja con el Sirius® que con el paquímetro ultrasónico, esta diferencia carece de significación clínica.AbstractObjectiveTo assess the repeatability and comparability of the central corneal thickness measurements obtained from a novel Scheimpflug camera with a Placido-disc topographer (Sirius®) and ultrasound pachymetry.Material and methodsIn a sample of thirty unoperated eyes of healthy subjects, the central corneal thickness was analyzed by a single examiner using the Sirius® and the ultrasound pachymeter. Repeatability of three sets of measurements from each device were evaluated using the coefficient of variation, standard deviation, and intraclass correlation coefficient. T-test with Bonferroni adjustment and Bland and Altman plots were used to assess agreement between devices.ResultsFor the Sirius® the coefficient of variation was 0.291%, and for the ultrasound pachymeter was 0.238%. The standard deviation was 0.123μm and 0.101μm for Sirius® and US respectively and the intraclass correlation coefficient was higher than 0.95 in all measurements. Ultrasound pachymetry systematically yielded higher values and statistically significant (mean 543.867 vs 558.267μm Sirius® and ultrasound pachymeter respectively), but the difference was not clinically significant.ConclusionIn the assessment of normal corneas, central corneal thickness measured with both devices showed high repeatability and good agreement. Even though central corneal thickness measurements obtained by Sirius® were systematically lower than those obtained by ultrasound pachymeter, they do not have clinical significance.

Wassia A Khaja, Sandeep Grover, Amy T Kelmenson, Lee R Ferguson, Kumar Sambhav, Kakarla V Chalam Department of Ophthalmology, University of Florida, College of Medicine, Jacksonville, FL, USA Background: Central corneal thickness (CCT) can be measured by using contact and non-contact methods. Ultrasound pachymetry (US pachymetry) is a contact method for measuring CCT and is perhaps the most commonly used method. However, non-contact methods like scanning slit topography (Orbscan II), slit-lamp optical coherence tomography (SL-OCT), and specular microscopy are also used. Not many studies have correlated the measurement of CCT with all four modalities. The purpose of this study was to compare and correlate the CCT measurements obtained by US pachymetry with SL-OCT, specular microscopy, and Orbscan. Method: This is a prospective, comparative study done in an institutional setting. Thirty-two eyes of 32 subjects with no known ocular disease and best-corrected visual acuity of 20/20 were enrolled. CCT measurements were obtained using SL-OCT, specular microscopy, scanning slit topography (Orbscan), and US pachymetry. Three measurements were made with each instrument by the same operator. Mean, standard deviation, and coefficient of variation were calculated for CCT measurements acquired by the four measurement devices. Bland–Altman plot was constructed to determine the agreements between the CCT measurements obtained by different equipment. Results: The mean CCT was 548.16±48.68 µm by US pachymetry. In comparison, CCT averaged 546.36±44.17 µm by SL-OCT, 557.61±49.92 µm by specular microscopy, and 551.03±48.96 µm by Orbscan for all subjects. Measurements by the various modalities were strongly correlated. Correlations (r2) of CCT, as measured by US pachymetry compared with other modalities, were: SL-OCT (r2=0.98, P