AIM: To evaluate the reliability of measurements of corneal changes with accommodation in healthy eyes using a Scheimpflug imaging-based system and how these measurements distribute in the normal population.METHODS: Prospective, non-randomized, comparative study including 27 healthy subjects(54 eyes), including emmetropia(13 eyes), myopia(17 eyes), hyperopia(4 eyes)and astigmatism(20 eyes)groups. In all cases, a complete eye examination was performed, including the analysis of corneal changes with different accommodative stimuli(+2.00, 0.00 and -3.00 D)using the Pentacam AXL system. The investigation was structured in 2 phases: repeatability analysis and characterization of accommodation-related corneal changes in healthy populations.RESULTS: In the repeatability analysis, the index of height asymmetry(IHA)showed the greatest variability with the three accommodative stimuli, being the results for the rest of parameters acceptable. The group of emmetropes showed significant differences with accommodative changes in the position of maximum keratometry(Kmax; P<0.05), whereas in the astigmatism group, significant changes were not only observed in the position of Kmax, but also in minimum corneal thickness(MCT), corneal spherical aberration, and total and low order aberration root mean square(all P<0.05). Likewise, a significant difference was found in the displacement of the X position of Kmax with +2.00 D and -3.00 D in the myopia group(P=0.033)as well as in changes with +2.00 D and -3.00 D in the magnitude of the position vector of Kmax in the emmetropia group(P<0.05). No significant changes were found between accommodative stimuli in the displacement of coordinates of MCT(P≥0.109).CONCLUSION: The position of Kmax and MCT in healthy corneas can change significantly when presenting different accommodative stimuli using the accommodation mode of the Pentacam system, with different trends in these accommodation-related corneal changes between refractive errors. Likewise, the consistency of the measurements obtained with Scheimpflug has been confirmed.