To Stitch or Not to Stitch, That Is the Question: Multi-Gaze Eye Topography Stitching Versus Single-Shot Profilometry

Purpose: To evaluate whether corneal topography map stitching can fully substitute the traditional single-shot capture methods in clinical settings. Methods: This record review study involved the measurement of corneal surfaces from 38 healthy subjects using two instruments: the Medmont Meridia, which employs a stitching composite topography method, and the Eye Surface Profiler (ESP), a single-shot measurement device. Data were processed separately for right and left eyes, with multiple gaze directions captured by the Medmont device. Surface registration and geometric transformation estimation, including neighbouring cubic interpolation, were applied to assess the accuracy of stitched maps compared to single-shot measurements. Results: The study evaluated eye rotation angles and surface alignment between Medmont topography across various gaze directions and ESP scans. Close eye rotations were found in the right-gaze, left-gaze and up-gaze directions, with rotation angles of around 8°; however, the down-gaze angle was around 15°, almost twice other gaze rotation angles. Root mean squared error (RMSE) analysis revealed notable discrepancies, particularly in the right-, left-, and up-gaze directions, with errors reaching up to 98 µm compared to ESP scans. Additionally, significance analyses showed that surface area ratios highlighted considerable differences, especially in the up-gaze direction, where discrepancies reached 70% for both right and left eyes. Conclusions: Despite potential benefits, the findings highlight a significant mismatch between stitched and single-shot measured surfaces due to digital processing artefacts. Findings suggest that stitching techniques, in their current form, are not yet ready to substitute single-shot topography measurements fully. Although stitching helps fit large-diameter contact lenses, care should be taken regarding the central area, especially if utilising the stitched data for optimising optics or wavefront analysis.