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Changes in the epithelial thickness profile have been found to be highly predictable, responding to compensate for changes in the stromal curvature gradient, using the eyelid as an outer template. This leads to characteristic changes in the epithelial thickness profile that can be used for early screening in keratoconus, postoperative monitoring for early signs of corneal ectasia, and for determining whether further steepening can be performed without the risk of apical syndrome following primary hyperopic treatment. Compensatory epithelial thickness changes are also a critical part of diagnosis in irregular astigmatism as these partially mask the stromal surface irregularities. The epithelial thickness map can then be used to plan a trans-epithelial photorefractive keratectomy treatment for cases of irregularly irregular astigmatism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjopt.sjopt_227_21","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:29:15Z","timestamp":1716186555000},"page":"25-35","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":22,"title":["Applications of epithelial thickness mapping in corneal refractive surgery"],"prefix":"10.4103","volume":"36","author":[{"given":"Dan Z.","family":"Reinstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Archer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan S.","family":"Vida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-5-20240830","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1001\/archopht.1960.01840010538009","article-title":"Cell production and migration in the epithelial layer of the cornea","volume":"64","author":"Hanna","year":"1960","journal-title":"Arch Ophthalmol"},{"key":"R3-5-20240830","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3928\/1081-597X-19950301-09","article-title":"Refractive index of the human corneal epithelium and stroma","volume":"11","author":"Patel","year":"1995","journal-title":"J Refract Surg"},{"key":"R4-5-20240830","first-page":"821","article-title":"Changes in thickness in the corneal layers","volume":"56","author":"Holden","year":"1979","journal-title":"Am J Optom"},{"key":"R5-5-20240830","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3928\/1081-597X-19930901-12","article-title":"High-frequency ultrasound measurement of the thickness of the corneal epithelium","volume":"9","author":"Reinstein","year":"1993","journal-title":"Refract Corneal Surg"},{"key":"R6-5-20240830","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/S0161-6420(94)31314-5","article-title":"Corneal pachymetric topography","volume":"101","author":"Reinstein","year":"1994","journal-title":"Ophthalmology"},{"key":"R7-5-20240830","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/S0161-6420(98)93211-0","article-title":"Three-dimensional ultrasound imaging. 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