Objective measurements of corneal light-backscatter during corneal swelling, by optical coherence tomography.

Abstract

To demonstrate that corneal light-backscatter can be measured objectively during corneal swelling by optical coherence tomography (OCT). One eye (randomly selected) of 20 non-contact-lens wearers (10 men and 10 women; mean age, 35.6 +/- 9.6 years) was patched during 3 hours of soft contact lens (SCL) wear. The contralateral eye acted as the control. Central corneal images were captured before and after SCL wear at 20-minute intervals over 100 minutes using optical coherence tomography (OCT) to obtain corneal thickness and light-backscatter profiles. OCT backscattered light of the epithelial layer (decided by the thickness measurements) and 10 equally divided layers of the remaining cornea were analyzed with a custom software program. Two baseline measurements were taken at different visits before lens wear to test the repeatability of light-backscatter measurements. From two baseline measurements, repeated measurements showed good repeatability of normalized backscatter results. Immediately after contact lens removal, total central corneal thickness increased significantly by 13.8% +/- 2.3% (mean +/- SD) compared with baseline (P = 0.0001, paired t-test) and then decreased during the deswelling course. Corneal backscattered light changed significantly (repeated-measures ANOVA [Re-ANOVA]: F((50, 950)) = 2.22, P = 0.0001) after lens wear, and a significant increase in backscatter was found in the epithelial layer (36.4%) and the most posterior corneal layer (35.6%) immediately after lens removal (post hoc test, P = 0.005). There was a strong correlation (r = 0.9375, P < 0.05) between the change in backscatter and corneal swelling during the deswelling period. The backscatter recovery rate was approximately the same for both epithelial and posterior layers after lens removal. Light-backscattering analysis with OCT seems to be a promising and repeatable method of objectively measuring corneal backscatter. This study has demonstrated that corneal backscattered light increased in the anterior and posterior layers of the cornea during corneal swelling induced by contact lens wear and eye closure.