Continuous Non-contact Corneal Pachymetry with a High Speed Reflectometer

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Abstract
PURPOSE: We developed an instrument that permits non-contact, continuous, high speed and high precision monitoring of corneal thickness and tested the stability and reproducibility of measurements made over extended time periods and under various conditions of low surface reflectivity encountered during protracted exposure of the unmoistened corneal surface to ambient air. METHODS: The optical pachymeter (basic component of a broad-band, all-fiber Michelson interferometer) was used to monitor changes in the central corneal thickness of enucleated porcine eyes. Measurements were performed on three groups of eight eyes, each with different surface characteristics: intact epithelium, mechanically abraded epithelium, and 90 µm excimer laser keratectomy. Corneal thickness was monitored continuously with values recorded every 2 to 3 minutes for periods up to 1 hour in the absence of surface rinsing. RESULTS: The thicknesses of all unmoistened corneas could be monitored with a precision of 1 µm (ascertained using a calibration glass plate and a living human cornea) over the entire observation period. Under ambient air conditions, deturgescence occurred in each case, and ranged from 1 to 5 µm/min. The rate of corneal thinning was fairly constant during the first 15 minutes of monitoring, but was nonlinear thereafter. Corneas with an intact epithelium had the lowest thinning rate with only 10% of the original thickness lost during the course of 1 hour. Deturgescence increased to 25% in corneas that had mechanical removal of the epithelium and to 28.5% in those that had an anterior excimer laser keratectomy, during a similar time-period. CONCLUSION: With this new interferometric method, continuous, non-contact measurement of corneal thickness is possible to within a precision of 1 µta for periods up to 1 hour, even under the modified surface conditions after photoablative keratectomy. This device may be useful for on-line monitoring of ablation depths during such procedures. [J Refract Surg 1998;14:140-146]