The importance of central corneal thickness measurements and decision making in general ophthalmology clinics: a masked observational study

Abstract

BackgroundTo assess the impact of knowing central corneal thickness (CCT) on glaucoma management in a United Kingdom district general hospital.MethodsA masked observational non-interventional study included 304 eyes of 152 consecutive glaucoma cases attending general clinic. CCT was measured using a hand-held pachymeter. IOP, as measured by the Goldmann applanation tonometer (GAT), was adjusted for CCT using a normogram. Two identical study sheets were retrospectively constructed from each subject's case notes: one included the CCT and adjusted IOP information, the other excluded. Study sheets were randomly presented to a single masked observer to decide glaucoma management. The difference in management decision was noted.ResultsThe mean ± standard deviation CCT was 561.5 ± 35.7 μm, 538.9 ± 41.4 μm, 538.3 ± 40.3 μm for ocular hypertension (OHT), primary open angle glaucoma (POAG) and normal pressure glaucoma (NPG) subjects respectively. IOP adjustment was greater than ±2 mmHg in 33.9%(103/304) of eyes. CCT and adjusted IOP information led to different treatment option in 37%(55/152). Of the most important changes 20.4%(31/152) cases would have been commenced on additional IOP-lowering medication, 2.0%(3/152) would have been counselled for trabeculectomy surgery and 3.3%(5/152) of the cohort would have been observed rather than treated.ConclusionCCT and adjusted IOP measurement can influence glaucoma management in a clinical context. It helps attribute risk and hence aids patient management decisions.

The Clinical Study to Assess the Corneal Thickness by Using Pachymetry in Various Types of Refractive Errors in Age Group (10 - 40 Yrs.)

“…Among 300 patients studied, we did not obtain any correlation between various refractive errors (spherical equivalent) and central corneal thickness. (1)(2)(3) In our study of 160 patients among 300 patients, Myopes average corneal thickness was 541 micrometres (SD 31). (1) Similar corneal thickness in both emmetropes and myopes.…”

“…and central corneal thickness. (1)(2)(3) There was slightly thinner cornea in high myopes and in myopic astigmatism. (4) Review of literature also indicates that decrease in corneal thickness in myopic patients is due to anterior segment change, as eyeball is elongated and emmetropes too had thinner Central Corneal Thickness.…”

The Effect of Cycloplegia on Optic Biometry in School

“…Bu bilgiye dayanarak MKK'de elde ettiğimiz farklar glokom hastalarının değerlendirilmesinde dikkate alınma-lıdır. 9 Ortalama SE değerlerinde damla sonrası elde ettiğimiz artış, akomodasyonun ortadan kalkmasıyla, özellikle çocuklarda beklenen artış ile uyumluydu. Özdemir ve ark.…”

“…1 Glokom tanı ve tedavisinde de, başta merkezi kornea kalınlığı (MKK) ve ön kamara derinliği (ÖKD) olmak üzere tüm biyometrik parametrilerin yeri vardır. 9 Her yaş grubunda uyum gücünün az veya çok klinik etkisini de göz önüne alarak, sikloplejinin optik biyometri ölçümleri üzerine etkisini okul çağı çocuklarında değerlendirmeyi hedefledik.…”

Central Corneal Thickness Measurement in Sub-Saharan Africa: Review

“…In India, the mean CCT was 531±32.9 μm (range, 448 to 626 μm) [58]. In UK, the mean CCT was 561.5 ± 35.7 µm, 538.9 ± 41.4 µm, 538.3 ± 40.3 µm for ocular hypertension (OHT), primary open angle glaucoma (POAG) and normal pressure glaucoma (NPG) subjects respectively [59].…”