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Published on: September 16, 2025
Determining the Utility of Epithelial Thickness Mapping in Refractive Surgery Evaluations
Lara Asroui1, William J Dupps1, J Bradley Randleman1
1From the Cole Eye Institute (L.A., W.J.D., J.B.R.), Department of Biomedical Engineering, Lerner Research Institute (W.J.D.), Cleveland Clinic, Department of Biomedical Engineering, Case Western Reserve University (W.J.D.), and the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (W.J.D, J.B.R) Cleveland, Ohio, USA.
Corneal epithelial thickness maps significantly impact refractive surgery candidacy, altering decisions for 16% of patients. These optical coherence tomography (OCT) maps improve screening by refining surgical choices and eligibility assessments.
Area of Science:
- Ophthalmology
- Medical Imaging
- Corneal Surgery
Background:
- Refractive surgery screening relies on various diagnostic methods.
- Corneal epithelial thickness is a critical factor in surgical outcomes.
- Standard screening may not fully capture individual corneal characteristics.
Purpose of the Study:
- To evaluate the influence of corneal epithelial thickness maps on refractive surgery candidacy.
- To compare screening outcomes with and without epithelial thickness data.
- To assess the impact on surgical procedure selection and eligibility.
Main Methods:
- 100 patients undergoing refractive surgery screening were analyzed.
- Initial screening used Scheimpflug tomography, clinical data, and patient history.
- Epithelial thickness maps from optical coherence tomography (OCT) were subsequently reviewed by masked examiners.
Main Results:
- Candidacy changed for 16% of patients (10% screened in, 6% screened out).
- Surgical procedure choice was altered for 16%, and procedure ranking for 25%.
- Eligibility for specific procedures like LASIK was affected, with no significant inter-examiner variability.
Conclusions:
- Corneal epithelial thickness mapping is a valuable tool for refractive surgery screening.
- OCT-derived epithelial maps significantly alter patient candidacy and surgical recommendations.
- Incorporating these maps enhances the precision of refractive surgery evaluations.
