The shape of the anterior and posterior surface of the aging human cornea

PURPOSE To determine the shape and astigmatism of the posterior corneal surface in a healthy population with age, using Scheimpflug photography corrected for distortion due to the geometry of the Scheimpflug imaging system and the refraction of the anterior corneal surface. METHODS Scheimpflug imaging was used to measure in six meridians the cornea of the right eye of 114 subjects, ranging in age from 18 to 65 years. RESULTS The average radius of the anterior corneal surface was 7.79+/-0.27 (SD) mm and the average radius of the posterior corneal surface was 6.53+/-0.25 (SD) mm. Both surfaces were found to be flatter horizontally than vertically. The cylindrical component of the posterior surface of 0.33 mm is twice that of the anterior surface (0.16 mm). The asphericity of both the anterior and the posterior surface was independent of the radius of curvature at the vertex, refractive error and gender. In contrast with that of the anterior corneal surface, the asphericity of the posterior corneal surface varied significantly between meridians. With age, the asphericity of both the anterior and the posterior corneal surface changes significantly, which results in a slight peripheral thinning of the cornea. CONCLUSION On average, the astigmatism of the posterior corneal surface (-0.305 D) compensates the astigmatism of the anterior corneal surface (0.99 D) with 31%. The results show that the effective refractive index is 1.329, which is lower than values commonly used. There is no correlation between the asphericity of the anterior and the posterior corneal surface. As a result, the shape of the anterior corneal surface provides no definitive basis for knowing the asphericity of the posterior surface.