The convergence of high-resolution imaging and clinically proven tomographic analysis has now become a reality! The Pentacam® Cornea OCT establishes a new standard in anterior segment imaging by combining ultra-high-resolution spectral-domain OCT with the proven precision of Scheimpflug tomography. This unique hybrid technology enables detailed visualization of corneal microstructures and supports precise diagnostics, surgical planning, and postoperative monitoring.1
A New Benchmark in Resolution
For over two decades, the Pentacam® platform has established itself as the gold standard in anterior segment tomography. With the introduction of the Pentacam® Cornea OCT, OCULUS bridges the gap between depth-resolved tomography and fine-structure visualization. This hybrid system combines Scheimpflug imaging for wide-area tomographic capture with a spectral-domain OCT in the 800 nm wavelength band. The device achieves an axial resolution of 1.9 µm and a lateral resolution of 10 µm, making it possible to visualize individual corneal layers, including the Epithelium, Bowman's layer, and the Endothelium.1 The "Wide Angle Pericentric Scanning" technology allows full corneal scans with maximum image fidelity, both centrally and peripherally, which previously was achievable only in ex vivo histological sections.1
Figure 1: Wide-angle pericentric scanning system of the Pentacam® Cornea OCT keeps the probing beam near-perpendicular to the corneal surface. By creating a measurement window adapted to the corneal curvature, the Pentacam® Cornea OCT's ultra-high resolution is optimally exploited to resolve the details of the corneal layer structure.
Dual-Technology Advantage: Scheimpflug + OCT
The Pentacam® Cornea OCT uniquely combines Scheimpflug imaging and spectral-domain OCT in one device. Scheimpflug technology remains the gold standard for anterior segment tomography! It delivers validated software modules based on topographic, tomographic and densitometric data supported by decades of clinical use. Meanwhile, the OCT module provides ultra-high-resolution cross-sections that reveal fine details such as Descemet's membrane ruptures or epithelial irregularities.1
This dual-modality approach enables simultaneous imaging at the same corneal location. While Scheimpflug detects scattering structures and supports normative databases, OCT enhances diagnostic precision through ultra-high structural resolution.1 Together, they provide an unprecedented level of diagnostic completeness in anterior segment imaging.
Clinically Validated Applications
The combined imaging modalities support advanced applications such as the Belin/Ambrósio Enhanced Ectasia Display – now in its 4th edition – epithelial thickness mapping, and corneal optical densitometry. These features aid in early ectasia detection, facilitate differential diagnosis for keratoconus, and enable detailed evaluation after refractive or therapeutic procedures.2,3,4
The Pentacam® Cornea OCT’s intuitive software interface integrates Scheimpflug and OCT data into a single combined workflow. The system captures 25 radial OCT scans matched to Scheimpflug images in less than a second. To fully leverage the ultra-high resolution, the OCT images are presented in the Cornea Zoom mode, enabling enhanced visualization of sub-layers and anomalies by stretching the image of the cornea axially. Beyond, the Real Shape mode allows for corneal analysis based on the true geometry. Enhanced image tools like the Averaging Mode further enhances diagnostic accuracy. It fuses up to 25 scans to create noise-free images that approach the clarity of histological specimens – a concept referred to as "optical biopsy".1
The following describes a case of a 65-year-old female patient presenting with unclear reduced uncorrected visual acuity of 20/30 in the right eye and 20/150 in the left eye and with distance-corrected visual acuity of 20/25 in the right eye and 20/40 in the left eye. After slit-lamp biomicroscopy, the left eye revealed classical epithelium changes consistent with Cogan dystrophy. Examination with the Pentacam® Cornea OCT confirms the diagnosis with detailed presentation of the abnormal epithelium layer. Scheimpflug images present the abnormality as a bright spot, indicating scattering structures. The OCT Image in the Cornea Zoom mode clearly shows the abnormal epithelium.
Figure 2: Slit-lamp biomicroscopy showing classical epithelium changes in Cogan dystrophy
Figure 3: Pentacam Cornea OCT’s Scheimpflug image with hyperreflective spot, typical in scattering structures
Figure 4: Pentacam Cornea OCT's Cornea Zoom image with stretched corneal thickness to visualize even the finest anatomical details
Future-Proof and Backward Compatible
The Pentacam® Cornea OCT is compatible with all existing Pentacam® data and integrates seamlessly into existing networks. This is indispensable for smooth follow-up examinations on patients in a familiar environment. Its software modules are floating-license-key enabled and support common EMR and DICOM interfaces. Pentacam users can transfer the licenses of their existing Pentacam® system to the new Pentacam® Cornea OCT. This ensures both clinical continuity and future scalability.
With the Pentacam® Cornea OCT, clinicians can visualize pathology with unprecedented clarity, make more informed decisions, and ultimately improve patient outcomes through next-generation corneal diagnostics.
The Pentacam® Cornea OCT is not just a technological upgrade – it is a platform for future diagnostic solutions. As corneal diagnostics evolve, so must our tools. The Pentacam® Cornea OCT is OCULUS’ next step in helping clinicians see more, detect earlier, and treat with confidence.
The views and opinions expressed here may not necessarily reflect those of Bryn Mawr Communications or Cataract & Refractive Surgery Today Global.
1. Ambrósio R Jr, Esporcatte LPG, de Carvalho KA, et al. Combined Rotating Ultra-High-Resolution Spectral Domain OCT and Scheimpflug Imaging for In Vivo Corneal Optical Biopsy. Diagnostics (Basel). 2024;14(13):1455. Published 2024 Jul 8. doi:10.3390/diagnostics14131455
2. Villavicencio OF et al. Independent Population Validation of the Belin/Ambrósio Enhanced Ectasia Display: Implications for Keratoconus Studies and Screening. Int J Kerat Ect Cor Dis. 2014;3(1):1–8. doi:10.5005/jp-journals-10025-1069
3. Correia et al. Topometric and Tomographic Indices for the Diagnosis of Keratoconus. Int J Kerat Ect Cor Dis. 2012;1(2):92-99. doi:10.5005/jp-journals-10025-1018
4. Reinstein DZ, Archer TJ, Vida RS. Epithelial thickness mapping for corneal refractive surgery. Curr Opin Ophthalmol. 2022;33(4):258-268. doi:10.1097/ICU.0000000000000867
5. Asroui L, Dupps WJ Jr, Randleman JB. Determining the Utility of Epithelial Thickness Mapping in Refractive Surgery Evaluations. Am J Ophthalmol. 2022;240:125-134. doi:10.1016/j.ajo.2022.02.021
6. Pircher N, Kilian R, Beer F, et al. Diagnostic performance of corneal epithelium- and Bowman's layer thickness mapping in patients with unilateral Keratoconus. Graefes Arch Clin Exp Ophthalmol. 2025;263(5):1383-1389. doi:10.1007/s00417-025-06750-8
7. Abusamak M, Issa SM, Alomari AF, et al. Corneal stromal mapping characteristics in normal corneas using anterior segment SD-OCT. Front Med (Lausanne). 2024;11:1485718. Published 2024 Dec 2. doi:10.3389/fmed.2024.1485718
8. Reisdorf S, Fayaz S; AI-Powered Assistant for Detecting Corneal Pathology in Optical Coherence Tomography Images. Invest. Ophthalmol. Vis. Sci. 2025;66(8):5413.
9. Tey KY, Cheong EZK, Ang M. Potential applications of artificial intelligence in image analysis in cornea diseases: a review. Eye Vis (Lond). 2024;11(1):10. Published 2024 Mar 7. doi:10.1186/s40662-024-00376-3
