Comparison of corneal thickness measured with optical coherence tomography, ultrasonic pachymetry, and a scanning slit method

Abstract

Purpose: To investigate the relationship between 1310-nm optical coherence tomography (OCT), an ultrasound pachymeter, and the Orbscan II (Bausch & Lomb, Rochester, NY) in corneal thickness measurements before and after LASIK.

Methods: Twenty-eight eyes of 14 patients with a mean age of 39.9 +/- 8.6 years underwent LASIK for correction of myopia with or without astigmatism. Central corneal thickness was measured with real-time 1310-nm OCT and Orbscan preoperatively and 1 day, 1 week, and 1 month postoperatively, and with an ultrasound pachymeter preoperatively and 1 month postoperatively.

Results: Measurements of corneal thickness by all instruments correlated well with one another pre- and postoperatively (r value range: 0.87 to 0.94, P<.05); however, there were significant differences among these methods (ANOVA: P<.005). Baseline readings for ultrasound and Orbscan were similar, as were readings 1 month postoperatively for OCT and Orbscan (P>.05). Thickness measured by OCT was thinner than for other instruments preoperatively (P<.005) and thicker than Orbscan postoperatively (P<.005). Significant corneal thinning (P<.001) was found with all study devices 1 day after laser ablation. Significant corneal thinning (P<.005) was found with OCT and Orbscan 1 week compared to 1 day postoperatively, and thickening (post hoc: P<.001) was evident at 1 month compared to 1 week postoperatively.

Conclusions: Although the instruments correlated well in measuring corneal thickness after LASIK, there were significant differences. All instruments indicated corneal swelling and recovery during the first postoperative week and thickening at 1 month.