Comparison of central corneal thickness measurements by Pentacam, noncontact specular microscope, and ultrasound pachymetry in normal and post-LASIK eyes

Abstract

Purpose To compare central corneal thickness (CCT) measurements taken with Pentacam, noncontact specular microscope (NCSM), and ultrasound pachymetry (US) in normal and post-laser in situ keratomileusis (LASIK) eyes and to assess the agreement between the three devices. Design Prospective clinical trial. Patients and methods Central corneal thickness (CCT) was measured in 94 eyes of normal volunteer and in 72 eyes of post-LASIK patients. Measurements were made with the three devices. Results In normal eyes, the mean (±SD) CCT taken with Pentacam, NCSM, and US was 552.6 ± 36.8 μm, 511.9 ± 38.6 μm, and 533.3 ± 37.9 μm, respectively. The average values of CCT taken with the three instruments were significantly different. In post-LASIK eyes the mean CCT with Pentacam, NCSM, and US was 483.02 ± 6.03 μm, 450.7 ± 5.3 μm, and 469.5 ± 5.8 μm, respectively. The average values of CCT taken were significantly different for Pentacam vs. NCSM ( P = 0.046) and Pentacam vs. US ( P = 0.02), but not significant for NCSM vs. US ( P = 0.352). The Bland and Altman method for assessing clinical agreement between 3 instruments showed that in normal eyes, the mean values and paired differences of the three CCT devices were found to be statistically independent. In post-LASIK eyes, there was significant association between the difference and the mean of the Pentacam and NCSM, and US and NCSM. Conclusion The three devices cannot be used interchangeably in normal and post-LASIK eyes. Pentacam tends to give significantly thicker reading than ultrasound pachymetry.