Comparison of central corneal thickness with four noncontact devices: An agreement analysis of swept-source technology

PURPOSE The purpose of this study was to compare the central corneal thickness (CCT) measurements of four noncontact devices in healthy eyes. MATERIALS AND METHODS In a sample of 45 healthy controls, CCT was measured using an optical biometer (IOLMaster 700) based on swept-source optical coherence tomography (SS-OCT), high-resolution rotating Scheimpflug camera system (Pentacam HR), spectral-domain OCT (SD-OCT) device with an anterior segment module (Spectralis), and noncontact pachymetry (NCP) device (Topcon TRK-2P). Agreement among the devices was analyzed using mean differences (i.e., bias) and Bland-Altman analysis with 95% limits of agreement (LoA). RESULTS Mean CCT measurements were 537.5 ± 47.5 μm for SS-OCT optical biometer, 532.3 ± 43.8 μm for Scheimpflug system, 521.3 ± 44.7 μm for SD-OCT device, and 518.0 ± 43.1 μm for NCP (P < 0.001). The SD-OCT device and NCP showed the closest agreement, with a bias of 2.6 μm (95% LoA, -3.6-8.8 μm), whereas the SS-OCT optical biometer and NCP showed the least agreement, with a bias of 18.7 μm (95% LoA, -2.1-39.5 μm). Bias was 16.1 μm (95% LoA, -3.1-35.3 μm) for SS-OCT optical biometer and SD-OCT, 5.1 μm (95% LoA, -6.8-17.0 μm) for SS-OCT optical biometer and Scheimpflug system, 10.9 μm (95% LoA, -15.1-36.9 μm) for SD-OCT device and Scheimpflug system, and 13.6 μm (95% LoA, -5-32.2 μm) for Scheimpflug system and NCP. CONCLUSIONS SS-OCT optical biometer overestimates CCT measurements compared to Scheimpflug system, SD-OCT device, and NCP. Given mean differences and range variations in CCT measurements between devices, SS-OCT optical biometer and Scheimpflug system are interchangeable as are SD-OCT and NCP.