Evaluation of a recently developed noncontact specular microscope in comparison with conventional pachymetry devices

The study was conducted to assess the central corneal thickness (CCT) of the healthy cornea with a recently developed noncontact specular microscope (EM-3000; Tomey) and compare the results with those measured with a contact specular microscope and an ultrasound pachymeter. Agreement between measurements taken by 2 investigators was also studied.

The right eyes of 41 healthy individuals who had negative history of contact lens wear, ophthalmic disease, or ocular surgery were examined. The CCT was determined sequentially with a noncontact specular microscope, a contact specular microscope (EM-1000; Tomey), and an ultrasound pachymeter (AL-2000; Tomey). Each evaluation with the specular microscopes was performed by 2 independent operators.

A significant difference was detected in pachymetry measurements among the 3 instruments (p=0.01; analysis of variance). The mean CCT values were lower measured with the ultrasound pachymeter (537+/-30 microm) than the contact endothelial microscope (543+/-37 microm, p=0.17, Student t-test) and the noncontact microscope (549+/-33 microm, p<0.0001) (operator 1). There was no statistically significant difference in CCT measurements between the 2 endothelial microscopes (p=0.19). We found significant correlations (p<0.0001) in thickness measurements between each pair of instruments (r=0.91, noncontact microscopy and ultrasound pachymetry; r=0.74, noncontact and contact microscopy; r=0.72, contact microscopy and ultrasound pachymetry; Spearman rank correlation).

The strong correlations among the 3 pachymetry devices suggest that the tested instruments provide reliable measurements; however, they cannot be used interchangeably.