Corneal Thickness Measurement in Turkey: Techniques, Applications and Cost

Pachymetry is a simple, quick, and painless examination used to measure the thickness of the cornea, an essential component of eye health.

In Turkey, corneal thickness measurement is performed using cutting-edge technologies, ensuring a safe, accurate, and comfortable experience for patients.

These advanced techniques, including Scheimpflug Imaging, Optical Coherence Tomography (OCT), and Ultrasound Pachymetry, are based on the latest innovations in ophthalmic care.

These methods allow for precise corneal health evaluations, playing a crucial role in diagnosing eye conditions such as glaucoma, keratoconus, and pre-surgical assessments for LASIK, helping clinicians offer tailored treatment plans for optimal patient outcomes.

In this article, we will explore the importance and process of corneal thickness measurement, the advanced techniques, and cost in Turkey

What is Corneal Thickness Measurement?

Corneal thickness measurement, known as Pachymetry, is a test for eye cornea to measure the corneal thickness, comparing the results with the normal range.

Corneal thickness may change in some eye diseases and it indicates some medical issues like glaucoma and refractive errors.

Measuring of overall corneal thickness in all parts has a different medical use than the measurement of the central corneal thickness.

Both are types of pachymetry and are measured by the same techniques and instruments however their medical indications vary

Pachymetry is a valuable indicator of corneal health, though its values can vary among healthy individuals.

The thinnest region of the cornea is typically located 1.5 mm temporally from the central cornea.

In general, corneal thickness ranges between 420 and 625 microns (μm), with an average central corneal thickness of 515 μm.

Why Measure the Corneal Thickness?

Corneal thickness measurement (Pachymetry) is used to assess corneal thickness in all areas, whether central or peripheral.

It has several important applications in ophthalmology, and it is a diagnostic tool for various eye conditions

Measuring corneal thickness is crucial for diagnosing various eye conditions like keratoconus and glaucoma.

It helps in pre-surgical evaluations (e.g., LASIK), assessing corneal edema (e.g., in Fuchs' dystrophy or uveitis), and monitoring the outcomes of corneal transplant surgeries. Additionally, corneal thickness measurement is important for accurately interpreting intraocular pressure readings in glaucoma management.

Thin or thick corneas can skew these readings, making precise measurements essential for correct diagnosis and treatment planning.

Conditions That Require Corneal Thickness Measurement

1. Diagnosis of corneal disorders:

Helps detect keratoconus, where the cornea becomes abnormally thin, especially in non-central areas.

2. Monitoring corneal edema:

In conditions such as Fuchs' dystrophy, a disorder caused by endothelial cell dysfunction, and uveitis, an inflammatory eye condition that can lead to uveitic corneal edema, fluid retention in the cornea results in increased thickness

However, other forms of uveitic edema, such as uveitic macular edema, cause fluid accumulation in different parts of the eye but do not affect the cornea or its thickness.

Measuring corneal thickness helps track disease progression and assess treatment effectiveness in both conditions.

3. Assessing corneal transplant outcomes (Keratoplasty):

After corneal transplant surgery, measuring thickness in different areas ensures the success of the procedure and the stability of the graft.

4. Other acute cases such as eye injuries and eye surgery

Used to evaluate changes in corneal thickness following injuries or other eye surgeries, such as cataract or glaucoma procedures.

Central Corneal Thickness Measurement

Central Corneal Thickness (CCT) specifically measures the thickness of the central part of the cornea.

Central corneal thickness (CCT) is an important parameter that is regularly assessed in clinical ophthalmology and plays a significant role in the diagnosis and monitoring of eye diseases.

Importance of Central Corneal Thickness Measurement

1. CCT is a critical parameter in ophthalmology; it can mask an accurate reading of intraocular pressure IOP.

Chronic elevation of the IOP can lead to glaucoma, a condition of progressive damage of optic nerve, if not treated this can end up with a permanent vision loss. Rapid glaucoma treatment is crucial for eyesight.

A thin cornea (below 420 microns) can lead to an underestimation of intraocular pressure (IOP) readings, meaning the actual pressure inside the eye may be higher than what the tonometer measures.

On the other hand, a thick cornea (above 625 microns) can cause an overestimation of IOP, meaning the measured pressure may appear higher than it actually is.

This can sometimes lead to unnecessary treatment if the true IOP is within a normal range.

2. Another important use of the CCT is in determining the suitability of the eye for refractive surgery such as LASIk eye surgery.

Very thin cornea: If the corneal thickness is less than 500 microns, the patient may not be a suitable candidate for LASIK.

Removing additional tissue could weaken the cornea, increasing the risk of keratoconus or post-LASIK ectasia.

Thick cornea: A thicker cornea is generally a better candidate for LASIK, as it provides sufficient tissue for reshaping while minimizing the risk of complications.

Techniques and Instruments for Measuring Corneal Thickness

Corneal thickness measurement techniques have evolved significantly in recent years.

While traditional techniques like ultrasound pachymetry and some forms of optical pachymetry are considered gold standard, they use instruments that require direct contact with the cornea.

However, advanced non-contact corneal thickness measurement instruments, such as Scheimpflug imaging, optical coherence tomography (OCT), and specular microscopy, provide highly accurate corneal thickness measurements without the need for corneal contact, enhancing patient comfort and reducing the risk of infection

Ultrasound Pachymetry Technique

Ultrasound pachymetry is the gold standard for central corneal thickness (CCT) measurement.

It uses a probe to emit ultrasonic sound waves, which reflect off the corneal layers to determine thickness.

Since the probe makes direct contact with the cornea, a topical anesthetic drop is administered in each eye.

The anesthetic effect lasts about 10–15 minutes, though the measurement itself takes only a few seconds per eye.

Optical Pachymetry Techniques

Optical pachymetry is a light-based imaging technique used to measure corneal thickness, in contrast to ultrasound-based methods. It measures the true thickness of the cornea by analyzing the optical properties of the corneal layers.

Advantages of optical pachymetry techniques include:

• High precision in measurement
• Ability to provide real-time imaging without the need for anesthesia
• Non-contact nature: Unlike ultrasound pachymetry, which requires direct corneal contact, optical pachymetry instruments offer a safer, more comfortable experience for patients while maintaining accuracy.

Most common types of optical pachymetry techniques:

1. Corneal Tomography: A technique that provides a three-dimensional reconstruction of the cornea, including measurements of both the anterior and posterior surfaces.

It includes methods like Scheimpflug Imaging and OCT, and is used for a more comprehensive assessment of corneal health, including thickness

2. Scheimpflug Imaging: Uses a rotating camera to create three-dimensional corneal maps, including high-resolution images of corneal layers, including thickness.
3. Optical Coherence Tomography (OCT): Uses low-coherence light waves to create cross-sectional images of the cornea.
4. OCT provides detailed imaging of the corneal structure, including precise measurements of corneal thickness.

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Pachymetry Preparation, Procedure and Results

Preparation:

Before undergoing pachymetry, there is generally little preparation required from the patient. However, certain guidelines should be followed:

No anesthesia or special preparation is needed in most cases. However, for certain methods like ultrasound pachymetry, an anesthetic eye drop may be administered to numb the cornea before the test.

No fasting or specific eye care instructions are necessary for most types of pachymetry. If you are using other eye medications, inform the healthcare provider prior to the test.

Procedure: The procedure for pachymetry is generally quick and non-invasive. It differs slightly based on the type of technique used:

During the pachymetry:

Ultrasound Pachymetry: A probe is placed gently on the surface of the cornea to measure thickness through sound waves.

The test is generally brief, and the patient may feel slight pressure during the process.

Optical Pachymetry (Scheimpflug Imaging, OCT, or Corneal Topography):

The patient is asked to sit in front of the pachymetry device.

The eye is aligned with the machine, and the technician captures the corneal image using light or scanning technology.

There is no contact with the eye, making the procedure comfortable and painless.

For OCT, the patient may need to focus on a light or image to keep their eye steady.

Pachymetry results interpretation

• The results of pachymetry give a precise measurement of the corneal thickness, typically in micrometers (µm).
• A normal central corneal thickness (CCT) ranges from 500 µm to 600 µm, but this can vary depending on the individual.
• Abnormal results may indicate potential eye conditions such as:

Thin corneas: Could be associated with conditions like keratoconus or increase the risk of complications during surgeries like LASIK.

Thick corneas: May indicate an increased risk of glaucoma or other ocular conditions.

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Applications of Corneal Thickness Measurement

Pachymetry has different applications in daily clinical practice, such as a complimentary examination for glaucoma, determining potential refractive surgery, or even diagnosing certain cornea diseases.

The most common application of corneal thickness measurement, pachymetry, in Turkey, include:

1. Pre-LASIK Evaluation

Besides other eye tests such as fundus examination, central corneal thickness measurement is essential in both the preoperative and postoperative management of corneal surgical procedures such as LASIK.

Preoperatively, it helps determine a patient’s eligibility and assess the risk of complications like corneal ectasia.

Postoperatively, it aids in monitoring corneal stability, healing, and detecting any abnormalities that may arise after the procedure.

2. Glaucoma Diagnosis and Management

Besides the IOP measurement tests performed routinely, sometimes Measuring central corneal thickness (CCT) is crucial in glaucoma assessment, as it influences the accuracy of intraocular pressure (IOP) readings.

Accurate CCT measurement helps ophthalmologists refine IOP readings and tailor glaucoma treatment plans accordingly.

3. Keratoconus Detection

Keratoconus is a progressive eye disorder where the cornea thins and gradually bulges into a cone shape, leading to distorted vision. It typically begins in adolescence or early adulthood and can cause increased sensitivity to light, blurred vision, and irregular astigmatism.

Corneal tomography is an effective tool to measure the thickness of the cornea.

This type of testing can often detect early signs of keratoconus before the disease is visible by slit-lamp examination.

Cost of Corneal Thickness Measurement in Turkey

The cost of corneal thickness measurement in Turkey is relatively affordable, typically ranging from $15 to $60 USD per test. This makes it an attractive option for patients seeking quality eye care at a reasonable price. In comparison to other countries, Turkey offers competitive pricing, particularly considering the advanced technology and skilled professionals available at many of its leading eye clinics.

This affordability, combined with high-quality services, makes Turkey an excellent destination for individuals who require corneal thickness assessments, whether for LASIK evaluations, glaucoma management, or keratoconus diagnosis.

Best Clinics for Corneal Thickness Measurement in Turkey

How can you choose the best clinic for corneal thickness measurement in Turkey?

1. Advanced Technology and Techniques: Look for clinics that utilize cutting-edge technologies like corneal tomography and optical scanning methods (e.g., Scheimpflug imaging, OCT). These techniques provide precise and reliable corneal thickness measurements.
   
2. Global Standards and Accreditation: Ensure the clinic follows international medical standards and is accredited. A clinic with certifications demonstrates commitment to high-quality care and patient safety.
   
3. Patient Reviews and Ratings: Research patient feedback and ratings to get insights into the clinic's service quality. Positive reviews indicate a high level of patient satisfaction and trust.
   
4. Experienced and Skilled Doctors: The clinic should have experienced ophthalmologists and staff who are skilled in diagnosing and treating corneal conditions. Ensure that the specialists are well-trained in corneal measurement and management.
   
5. Payment Options: Consider clinics that offer flexible payment options. This can make the process more convenient and affordable.

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FAQ

What is central corneal thickness measurement?
Central corneal thickness (CCT) measurement refers to the process of determining the thickness of the central part of the cornea, which is important for diagnosing and managing eye conditions like glaucoma and keratoconus.

How is corneal thickness measured?
Corneal thickness is measured using non-invasive techniques such as Scheimpflug imaging, Optical Coherence Tomography (OCT), and ultrasound pachymetry.

What instruments are used for corneal thickness measurement?
Instruments used include Scheimpflug cameras, OCT devices, ultrasound pachymeters, and optical pachymeters.

Where can I get corneal thickness measurement in Turkey?
You can get corneal thickness measurement at specialized eye clinics and hospitals across Turkey, particularly those offering advanced ophthalmic services.