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The purpose was to determine the interchangeability of ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) for corneal opacity depth measurement.Twenty-six eyes of 26 consecutive patients with corneal opacities were examined by both AS-OCT and UBM. The corneal thickness and the corneal opacity depth were measured and compared. The interchangeability was determined by Bland–Altman plotting.The difference in the full corneal thickness and in the corneal opacity depth between OCT and UBM was 5 ± 7 μm and −1 ± 8 μm, respectively. There were strong correlations and no significant differences between the paired parameters (all r > 0.99, P < 0.01). The limits of agreement were 5 ± 14 μm for the corneal thickness and −1 ± 14.8 μm for the corneal opacity depth.AS-OCT and UBM may be used interchangeably for measuring both full corneal thickness and corneal opacity depth in patients with corneal opacity.