Khairidzan Mohd Kamal MD

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Khairidzan Mohd Kamal MD Comparison of Central Corneal Thickness and Anterior Chamber Depth Measurements between Anterior Segment Optical Coherence Tomography and Scheimpflug Imaging Khairidzan Mohd Kamal MD Department of Ophthalmology, Faculty of Medicine, International Islamic University Malaysia The author have no financial interest in the subject matter of this poster

Introduction Accurate and reliable determination of anterior segment biometry is important in laser and lens refractive surgery Central Corneal Thickness Anterior Chamber Depth Indicator for corneal metabolism and hydration status Important parameter in characterization of corneal disease Basic parameter in the planning of laser refractive surgery Determine the actual position of the lens. Assessment of accommodation-induced configuration changes of the phakic eye Useful parameter in the planning of lens refractive surgery Ultrasound pachymetry has been the traditional “gold standard” for biometry measurement. However, the are newer non-contact optical technologies available. Biometric Technology Slit scanning Anterior Segment OCT Partial Coherent Interferometry Scheimpflug Imaging We sought to evaluate the comparability of different non-contact methods for the analysis of the central corneal thickness and anterior chamber depth in the phakic eye

Purpose Methods Central Corneal Thickness The study is to compare two different non-contact In measuring Anterior Chamber Depth Anterior Segment Optical Coherent Tomography (ASOCT) The image-acquisition system provides a video image of the examined zone and stores the last 7 images at a rate of 8 frames per second The software interprets the selected image. The image is reconstructed to provide biometry information Scheimpflug Imaging (SI) Sectional image were measured and recorded CCD camera rotates and provides section planes from three spatial planes The measured data obtained are used to calculate a 3D model from which the thickness and the anterior chamber depth can be computed Methods Strategy Subjects Tools Measurements Cross sectional Prospective 108 healthy eyes 54 subjects aged 20-25 years old IIUM Eye Specialist Clinic Kuantan Pahang. Anterior Segment Optical Coherent Tomography Scheimpflug Imaging Central Corneal Thickness Anterior Chamber Depth

Result Variables Mean (SD) µm Mean difference (95% CI) µm p-value CCT (ASOCT) 526.61 (28.06) -13.42 (-14.54 to -11.95) p<0.05 CCT (Scheimpflug) 539.85 (27.01) Variables Mean (SD) µm Mean difference (95% CI) µm p-value ACD (ASOCT) 3.17 (0.23) 0.06 (0.05 to 0.07) p<0.05 ACD (Scheimpflug) 3.11 (0.24) The mean difference (95% CI) of CCT between the methods was 13.42 (± 6.79) µm with p value <0.05. The mean difference in ACD between the methods was 0.06 (±0.072) mm with p value <0.05

Result In Pearson’s correlation, the observed linear correlation between ASOCT and Scheimpflug score was r = 0.972 for CCT. The observed linear correlation between ASOCT and Scheimpflug score was r = 0.956 for ACD.

Result In Bland –Altman analysis, Approximately 105/108 (95%) ASOCT-Scheimpflug differences were within the 95% CI interval for the mean difference of CCT. Approximately 106/108 (94%) ASOCT-Scheimpflug differences were within the 95% CI interval for the mean difference of the mean difference of ACD.

Discussion This study can serve as the basis of the clinical decision making in the comparison between ASOCT and Scheimpflug imaging. The Central Cornea Thickness (CCT) measurement using Scheimpflug Imaging was higher by 13. 42±6.79 µm than ASOCT For Anterior Chamber Depth (ACD), ASOCT provided higher measurement compared to Scheimpflug imaging by 0.06±0.072 mm. These result a statistical significant difference. Both instruments had a good correlation and agreement in measuring CCT and ACD.

References Al-Mezaine H. S., Al-Amro S. A., Kangave D., Sadaawy A., Wehaib T. A., Al-Obeidan S. Comparison Between Central Corneal Thickness Measurements by Oculus Pentacam and Ultrasonic Pachymetry. Int Ophthalmol 2007. Barkana Y. Gerber Y. Elbaz U., Schwartz S., Ken-Dror G., Avni I., Zadok D. Central Corneal Thickness Measurement with the Pentacam Scheimpflug System, Optical Low Coherence Reflectometry Pachymetry and Ultrasound pahcymetry. J Cataract Refract Surg 2005; 31: 1729-1735. Buehl, W., Stojanac, D., Sacu, S., Drexler, W., & Findl, O. (2006).Comparison of three methods of measuring corneal thickness and anterior chamber depth. American Journal of Ophthalmology, 141, 1. Meinhardt, B., Stachs, O., Stave, J., Beck, R., & Guthoff, R. (2006). Evaluation of biometric methods for measuring the anterior chamber depth in the non-contact mode. Graefe’s Arch Clinical Experimental Ophthalmology, 244, 559-564. Wolffsohn, J. S., & Peterson, R. C. (2006). Anterior ophthalmic imaging. Clinical and Experimental Optometry, 89, 4, 205-214. Wolffsohn, J. S., & Davies, L. N. (2007). Advances in anterior segment imaging. Current Opinion in ophthalmology, 18, 32-38.