Repeatability and agreement of corneal thickness measurements by three methods of pachymetry in small incision lenticule extraction eyes

<b>Background</b>: The accurate evaluation of corneal thickness (CT) post small incision lenticule extraction (SMILE) is clinically relevant to reduce the risk of complications. We aimed to analyze repeatability and agreement of central corneal thickness (CCT), thinnest corneal thickness (TCT), and mid-peripheral corneal thickness (MPCT) measurements using Scheimpflug imaging, anterior segment swept-source optical coherence tomography (AS-SS-OCT, CASIA 1000, Tomey), and ultrasound pachymetry (USP, SP-3000, Tomey) in eyes with previous SMILE. <b>Methods</b>: Ninety-one eyes of 91 patients were included. Within-subject standard deviation (Sw), test-retest repeatability (TRT), intraclass correlation coefficient (ICC), and coefficient of variation (CoV) were used to evaluate repeatability. Agreement was assessed by repeat-measurement analysis of variance and Bland–Altman analysis. <b>Results</b>: The above three instruments revealed that Sw was &lt;5.91 µm, CoV was &lt;1.08%, TRT was &lt;16.38 µm, and ICC was &gt;0.94. The 95% limits of agreement were relatively narrow and Bland–Altman plots were more concentrated at the CCT, at the TCT, and at the CT_2mm. However, it was shown to be wide at the CT_5mm. <b>Conclusions</b>: The three devices provide good repeatability of CT measurements in patients who undergone SMILE. Agreement between measurements at the CCT, TCT, and CT_2mm were high, but measurement agreements among CT_5mm revealed poor agreement.