Corneal pachymetry is the process of measuring the thickness of the

cornea The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical power ...

. A pachymeter is a

medical device A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...

used to measure the thickness of the eye's

. It is used to perform corneal pachymetry prior to

refractive surgery Refractive eye surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileu ...

, for Keratoconus screening, LRI surgery and is useful in screening for patients suspected of developing

glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...

among other uses.

Process

It can be done using either ultrasonic or optical methods . The contact methods, such as

ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...

and optical such as confocal microscopy (CONFOSCAN), or noncontact methods such as optical biometry with a single Scheimpflug camera (such as SIRIUS or PENTACAM), or a Dual Scheimpflug camera (such as GALILEI), or Optical Coherence Tomography (OCT, such as Visante) and online Optical Coherence Pachymetry (OCP, such as ORBSCAN). Corneal Pachymetry is essential prior to a

procedure for ensuring sufficient corneal thickness to prevent abnormal bulging of the cornea, a side effect known as ectasia.

Pachymeters

The instrument used for this purpose is known as a ''pachymeter''. Conventional pachymeters are devices that display the thickness of the cornea, usually in micrometres, when the ultrasonic transducer touches the cornea. Newer generations of ultrasonic pachymeters work by way of

Corneal Waveform (CWF) Corneal pachymetry is the process of measuring the thickness of the cornea. A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to refractive surgery, for Keratoconus ...

. Using this technology the user can capture an ultra-high definition echogram of the cornea, somewhat like a corneal A-scan. Pachymetry using the corneal waveform process allows the user to more accurately measure the corneal thickness, verify the reliability of the measurements that were obtained, superimpose corneal waveforms to monitor changes in a patient's cornea over time, and measure structures within the cornea such as micro bubbles created during femto-second laser flap cuts.

Indications

Corneal pachymetry is essential for other corneal surgeries such as Limbal Relaxing Incisions. LRI is used to reduce corneal

astigmatism Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at nig ...

by placing a pair of incisions of a particular depth and arc length at a steep axis of corneal astigmatism. By using the corneal pachymetry the surgeon will reduce the chances of perforation of the eye and improves surgical outcome. Newer generations of pachymeters will help surgeons by providing graphical surgical plans to eliminate astigmatism. Corneal pachymetry is also considered an important test in the early detection of

. In 2002, the five-year report of the Ocular Hypertension Study (OHTS) was released. The study reported that corneal thickness as measured by corneal pachymetry was an accurate predictor of glaucoma development when combined with standard measurements of

intraocular pressure Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to ...

. As a result of this study and others that followed, corneal pachymetry is now widely used by both glaucoma researchers and glaucoma specialists to better diagnose and detect early cases. Newer generation pachymeters have the ability to adjust the intraocular pressure that is measured according to the corneal thickness.

Technology

Modern devices use ultrasound technology, while earlier models were based on optical principles. The ultrasonic Pachymeters traditionally have been devices that provide the thickness of the human cornea in the form of a number in micrometres that is displayed to the user. The newer generation of ultrasonic pachymeters work by way of

. Using this technology the user can capture an ultra high definition echogram of cornea, think of it as a corneal A-scan. Pachymetry using the corneal waveform allows the user to more accurately measure the corneal thickness, have the ability to check the reliability of the measurements that were obtained, have the ability to superimpose corneal waveform to monitor the change of patients cornea over time, and ability to measure structures within the cornea such as micro bubbles created in the cornea during femto-second laser flap cut.

References

{{Reflist Eye procedures