Comparison of central corneal thickness using non-contact tono-pachymeter (Tonopachy) with ultrasound pachymetry in normal children and in children with refractive error

Corneal Characteristics of Myopic Malay School Children and Their Association with Axial Length

Introduction

Corneal characteristics are unique to each eye and can vary among different levels of refractive errors. However, minimal data are available in the literature on corneal characteristics in myopic Malay school children including the difference between the low myopic group and the moderate myopic group. Therefore, this study aims to determine the corneal characteristics of myopic Malay school children and their associations with axial length.

Methods

A total of eighty-four data samples were extracted from forty-two myopic Malay school children. Measurements of the central corneal thickness (CCT), corneal curvature, corneal diameter, and axial length were measured using Lenstar LS900, a non-contact optical biometer. Data were later stratified by the spherical equivalent refraction (SER) into a low myopic group and a moderate myopic group, and paired t-test were employed to determine the differences in the corneal characteristics between these two groups. Univariate and multivariate linear regressions were performed to identify factors that are significantly associated with axial length.

Results

There was no significant difference in the CCT, corneal curvature and corneal diameter between the low myopic group and the moderate myopic group (t82=0.015, P=0.99), (t82=-0.802, P=0.43) and (t82=-0.575, P=0.57), respectively. Pearson univariate correlation analysis found that axial length significantly correlated with corneal curvature (r=-0.765, P<0.001) and corneal diameter (r=0.614, P<0.001) but no significant correlation found with CCT (r=0.046, P=0.68). Multiple regression analysis showed that axial length was significantly associated with a flatter corneal curvature (P<0.001), older age (P<0.001) and larger corneal diameter (P=0.02).

Conclusion

This study reported the corneal characteristics in myopic Malay school children and its associations with axial length. Results of this study can serve as a reference value for the myopic Malay schoolchild population.

Comparison of central corneal thickness measurements with different non-contact devices in healthy children

PURPOSE

To investigate the agreement of the Combined Scheimpflug-Placido Disk System (Sirius), specular microscopy (Tomey EM-4000), non-contact tono-pachymetry (Canon TX-20P), and optical low-coherence reflectometry (Lenstar LS 900) devices in the measurement of central corneal thickness (CCT) in healthy children.

METHOD

Eighty-three eyes from 83 healthy children were included in the study. The mean age of the children was 11.1 ± 2.8 (range, 7-17) years. CCT was measured using the Sirius topography, Tomey specular microscopy, Canon TX-20P, and Lenstar LS 900 devices. To examine the agreement among these devices, 95% limits of agreement (LoA) and intraclass correlation coefficients (ICC) were determined.

RESULTS

The mean CCT values obtained using the Sirius topography, Tomey SM, Canon TX-20 P, and Lenstar 900 devices were 555.9 ± 37 µm, 553.5 ± 39 µm, 569.3 ± 33 µm, and 559.7 ± 38 µm, respectively. With the ICC method, the agreement rates were determined as 0.875 between Canon TX-20P and Sirius topography, 0.903 between Canon TX-20P and Lenstar LS 900, 0.842 between Canon TX-20P and Tomey EM-4000, 0.979 between Sirius Topography and Lenstar LS 900, 0.978 between Sirius topography and Tomey EM-4000, and 0.969 between Lenstar LS 900 and Tomey EM-4000.

CONCLUSION

The devices with the closest results to each other were the Sirius and Tomey EM-4000 devices, with a statistically strong agreement. There was also a strong agreement between Sirius and Lenstar LS 900, although there was a 3.7-unit difference between them. Nevertheless, despite the strong agreements among these devices, because their CCT values varied statistically significantly, these devices should not be used interchangeably in clinical practice.