Comparison of central corneal thickness and endothelial cell measurements by Scheimpflug camera system and two noncontact specular microscopes

PurposeTo investigate the correlation of Scheimpflug camera system and two noncontact specular microscopes in terms of central corneal thickness (CCT) and corneal endothelial cell morphology measurements.MethodsOne hundred eyes of 50 healthy subjects were examined by Pentacam Scheimpflug Analyzer, CEM-530 (Nidek Co, Ltd, Gamagori, Japan) and CellChek XL (Konan Medical, California, USA) via fully automated image analysis with no corrections made. Measurement differences and agreement between instruments were determined by intraclass correlation analysis.ResultsThe mean age of the subjects was 36.74 ± 8.59 (range 22–57). CCTs were well correlated among all devices, with having CEM-530 the thinnest and CellChek XL the thickest measurements (intraclass correlation coefficient (ICC) = 0.83; p < 0.001 and ICC = 0.78; p < 0.001, respectively). Mean endothelial cell density (ECD) given by CEM-530 was lower than CellChek XL (2613.17 ± 228.62 and 2862.72 ± 170.42 cells/mm2, respectively; ICC = 0.43; p < 0.001). Mean value for coefficient of variation (CV) was 28.57 ± 3.61 in CEM-530 and 30.30 ± 3.53 in CellChek XL. Cell hexagonality (HEX) with CEM-530 was higher than with CellChek XL (68.70 ± 4.16% and 45.19 ± 6.58%, respectively).ConclusionsECDs with CellChek XL and CEM-530 have good correlation, but the values obtained by CellChek XL are higher than CEM-530. Measurements for HEX and CV differ significantly and show weak correlation. Thus, we do not recommend interchangeable use of CellChek XL and CEM-530. In terms of CCTs, Pentacam, CEM-530 and CellChek XL specular microscopy instruments are reliable devices.

[1]  S. Kaufman,et al.  Corneal thickness measurements with the Topcon SP-2000P specular microscope and an ultrasound pachymeter. , 1999, Archives of ophthalmology.

[2]  B. Nayak,et al.  Comparison of corneal endothelial cell loss during phacoemulsification using continuous anterior chamber infusion versus those using ophthalmic viscosurgical device: Randomized controlled trial , 2009, Indian journal of ophthalmology.

[3]  K. Pesudovs,et al.  A Comprehensive Comparison of Central Corneal Thickness Measurement , 2011, Optometry and vision science : official publication of the American Academy of Optometry.

[4]  M. Garza-León.  Corneal endothelial cell analysis using two non-contact specular microscopes in healthy subjects , 2016, International Ophthalmology.

[5]  G. Savini,et al.  A Comparison between Scheimpflug imaging and optical coherence tomography in measuring corneal thickness. , 2013, Ophthalmology.

[6]  S. Tseng,et al.  Specular microscopy of hard contact lens wearers. , 1984, Ophthalmology.

[7]  S. Panagopoulou,et al.  Endothelial cell density after photorefractive keratectomy for moderate myopia using a 213 nm solid‐state laser system , 2007, Journal of cataract and refractive surgery.

[8]  O. Arslan,et al.  Corneal Endothelial Cell Density and Morphology in Healthy Turkish Eyes , 2014, Journal of ophthalmology.

[9]  T. Olsen.  OPTICAL PRINCIPLES FOR ESTIMATION OF ENDOTHELIAL CELL DENSITY WITH THE NON‐CONTACT SPECULAR MICROSCOPE , 1979, Acta ophthalmologica.

[10]  R. Ašoklis,et al.  Clinical Interventions in Aging Dovepress Age-related Changes in Corneal Thickness and Endothelial Characteristics Saulius Galgauskas Dovile ˙ Norvydaite ˙ , 2022 .

[11]  K. T. Nguyen,et al.  Assessment of the Reliability of Calculations of the Coefficient of Variation for Normal and Polymegethous Human Corneal Endothelium , 1993, Optometry and vision science : official publication of the American Academy of Optometry.

[12]  S. Moghimi,et al.  Corneal endothelial cell density and morphology in normal Iranian eyes , 2006, BMC ophthalmology.

[13]  M. Stur,et al.  Influence of viscoelastic substances used in cataract surgery on corneal metabolism and endothelial morphology: comparison of Healon and Viscoat , 2001, Journal of cataract and refractive surgery.

[14]  T. Walkow,et al.  Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. , 2000, Journal of cataract and refractive surgery.

[15]  G. Savini,et al.  Comparison and Evaluation of Central Corneal Thickness Using 2 New Noncontact Specular Microscopes and Conventional Pachymetry Devices , 2014, Cornea.

[16]  Ken Hayashi,et al.  Cataract surgery in eyes with low corneal endothelial cell density , 2011, Journal of cataract and refractive surgery.

[17]  O. Findl,et al.  Comparison of 4 Specular Microscopes in Healthy Eyes and Eyes With Cornea Guttata or Corneal Grafts , 2015, Cornea.

[18]  G. Rose.  Clinical assessment of corneal endothelial cell density: an original system of grading using a slit-lamp biomicroscope. , 1986, The British journal of ophthalmology.

[19]  D. Böhringer,et al.  Comparison of corneal endothelial cell measurements by two non-contact specular microscopes , 2015, BMC Ophthalmology.

[20]  R. Beck,et al.  Endothelial morphometric measures to predict endothelial graft failure after penetrating keratoplasty. , 2013, JAMA ophthalmology.

[21]  Haya Matuoq Al Farhan,et al.  Assessment of central corneal thickness and corneal endothelial morphology using ultrasound pachymetry, non-contact specular microscopy, and Confoscan 4 confocal microscopy. , 2013 .

[22]  Corneal endothelial photography. Three-year revision. American Academy of Ophthalmology. , 1997, Ophthalmology.

[23]  H. Edelhauser.  The Resiliency of the Corneal Endothelium to Refractive and Intraocular Surgery , 2000, Cornea.

[24]  S. Ganekal,et al.  Comparison of Morphological and Functional Endothelial Cell Changes after Cataract Surgery: Phacoemulsification Versus Manual Small-Incision Cataract Surgery , 2014, Middle East African journal of ophthalmology.

[25]  M. Knorz,et al.  Central corneal volume and endothelial cell count following femtosecond laser-assisted refractive cataract surgery compared to conventional phacoemulsification. , 2012, Journal of refractive surgery.

[26]  M. Doughty.  A prospective analysis of corneal endothelial polymegethism and cell density in young adult Asians , 2014, Clinical & experimental optometry.

[27]  B. Acar,et al.  Changes in endothelial cell density following penetrating keratoplasty and deep anterior lamellar keratoplasty. , 2011, International journal of ophthalmology.

[28]  Michael J Lynn,et al.  Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices, and new intraocular drugs and solutions. , 2008, Cornea.

[29]  Ross Gagliano,et al.  Review of , 2006, UBIQ.

[30]  Ö. Uçakhan,et al.  Corneal thickness measurements in normal and keratoconic eyes: Pentacam comprehensive eye scanner versus noncontact specular microscopy and ultrasound pachymetry , 2006, Journal of cataract and refractive surgery.

[31]  T. Olsen.  NON‐CONTACT SPECULAR MICROSCOPY OF HUMAN CORNEAL ENDOTHELIUM , 1979, Acta ophthalmologica.

[32]  B. Seitz,et al.  Corneal endothelial cell density and pachymetry measured by contact and noncontact specular microscopy , 2002, Journal of cataract and refractive surgery.

[33]  P. A. Mohammad-Salih,et al.  Corneal endothelial cell density and morphology in normal Malay eyes. , 2011, The Medical journal of Malaysia.

[34]  T. Cumurcu,et al.  Serum homocysteine, vitamin B 12 and folic acid levels in different types of glaucoma , 2006, BMC ophthalmology.

[35]  B. Dick,et al.  Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser–assisted cataract surgery: Three‐month follow‐up , 2013, Journal of cataract and refractive surgery.

[36]  R. Holzchuh,et al.  The Endothelial Sample Size Analysis in Corneal Specular Microscopy Clinical Examinations , 2012, Cornea.

[37]  R. Khoramnia,et al.  Central and peripheral pachymetry measurements according to age using the Pentacam rotating Scheimpflug camera , 2007, Journal of cataract and refractive surgery.