Relationship between axial length, keratometry and central corneal thickness in patients with refractive errors at a teaching hospital in Southwest, Nigeria

Background: Aim of the study was to determine the relationship between axial length (AL), keratometry and central corneal thickness (CCT), and refractive errors in adult patients attending the Guinness eye centre (GEC), Lagos university teaching hospital (LUTH) Idi-Araba, Lagos. Methods: A descriptive cross-sectional study conducted among consecutive patients aged 16 years and above with refractive errors attending the GEC, LUTH. Ocular parameters measured included AL, anterior corneal curvature, CCT and refractive errors. AL and keratometry were measured with IOL master and CCT with ultrasonic A scan pachymeter. Refraction was done with auto-refractor-keratometer. Data analysis was done with statistical package for social science (SPSS) 20. Results: A total of 394 patients were studied, 157 males and 237 females. The age range was 16-65 years, mean -37.9±13.3 years and median -36.5 years. There were more myopic patients 215 (54.6%) than hyper-metropes 179 (45.4%). The mean AL was 23.9±1.1 mm and eyes with longer AL were more likely to be myopic (r=-0.676, p<0.001); to have flatter cornea (r=0.519, p<0.001) and thicker cornea (r=0.149, p=0.003). The mean CCT was 520.3±31.0 µm. There was a weak negative correlation between CCT and refractive error (r=-0.111, p=0.027). Conclusions: The mean CCT was lower than the mean CCT of other Nigerian studies. Hypermetropic patients were more likely to have thinner corneas . This may lead to underestimation of intraocular pressure (IOP) in these patients . Significant correlation was seen between AL and refractive error, CCT and keratometry. AL correlated with less spherical equivalent refractive error, flatter and thicker cornea. It is therefore important to measure the CCT of all patients going for refractive surgery to detect those at risk of developing corneal ectasia following refractive surgery.