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Central Corneal Thickness Measurements With Different Imaging Devices and Ultrasound Pachymetry

Tai, Lai-Yong MBBS*; Khaw, Keat-Ween FRCOphth*; Ng, Choung-Min PhD; Subrayan, Visvaraja FRCOphth*

doi: 10.1097/ICO.0b013e318269938d
Clinical Science

Purpose: The aim of this study was to compare 4 methods of central corneal thickness (CCT) measurements in terms of their agreement, repeatability, and measurement time.

Methods: CCT was measured in 184 eyes of 92 healthy subjects by the same examiner. The methods used were as follows: noncontact specular microscopy (SM; Topcon SP-3000P; Topcon Corporation, Tokyo, Japan), Pentacam rotating Scheimpflug photography system (Oculus Inc, Wetzlar, Germany), optical low-coherence reflectometry (OLCR; LenStar LS900; Haag-Streit AG, Koeniz, Switzerland), and ultrasound pachymetry (UP; PachPen; Accutome Inc, Malvern, PA). The duration for each examination was measured by an independent observer.

Results: The mean age (±SD) of the subjects was 54.3 (±15.3) years. The mean CCTs (±SD) for SM, Pentacam, OLCR, and UP were 507.8 (±30.2), 538.4 (±31.7), 531.8 (±31.4), and 528.3 (±32.9) μm, respectively. The Bland–Altman plots showed closest agreement for OLCR–UP, followed by OLCR–Pentacam and Pentacam–UP. SM had the poorest agreement with the other methods. CCTs measured by SM were on average 20 to 30 μm thinner than those of the other methods. The coefficient of repeatability for SM, Pentacam, OLCR, and UP were 3.14%, 4.23%, 1.51%, and 3.46%, respectively. The mean measurement times (±SD) were 13.5 (±5.7), 45.7 (±12.3), 18.5 (±7.1), and 5.6 (±1.0) seconds, respectively.

Conclusions: CCT measurements between OLCR–UP and OLCR–Pentacam are comparable and can be used interchangeably in clinical practice. However, SM underestimates CCT compared with the other methods, whereas Pentacam was found to be the least repeatable and took the longest time.

*Department of Ophthalmology, University of Malaya Medical Center, Kuala Lumpur, Malaysia

Institute of Mathematical Sciences, University of Malaya, Kuala Lumpur, Malaysia.

Reprints: Keat Ween Khaw, Department of Ophthalmology, University of Malaya Medical Center, Lembah Pantai, 59100 Kuala Lumpur, Malaysia (e-mail:

Supported by the High Impact Research Grant H-20001-00-E000058.

The authors have no financial or proprietary interest in any of the materials or methods mentioned in this article.

Received May 15, 2012

Accepted July 11, 2012

© 2013 by Lippincott Williams & Wilkins.