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      Corneal biomechanical properties in healthy children measured by corneal visualization scheimpflug technology

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          Abstract

          Background

          The aim of this study was to evaluate corneal biomechanical properties in a population of healthy children in China using corneal visualization Scheimpflug technology (CST).

          Methods

          All children underwent complete bi-ocular examinations. CST provided intraocular pressure (IOP) and corneal biomechanical parameters, including time, velocity, length and deformation amplitude at first applanation (A1T, A1V, A1L, A1DA), at second applanation (A2T, A2V, A2L, A2DA), highest concavity time (HCT), maximum deformation amplitude (MDA), peak distance (PD), and radius of curvature (RoC). Pearson correlation analysis was used to assess the impacts of demographic factors, central corneal thickness (CCT), spherical equivalent (SE), and IOP on corneal biomechanics.

          Results

          One hundred eight subjects (32 girls and 76 boys) with the mean age of 10.80 ± 4.13 years (range 4 to18 years) were included in the final analyses. The right and left eyes were highly symmetrical in SE ( p = 0.082), IOP ( p = 0.235), or CCT ( p = 0.210). Mean A1T of the right eyes was 7.424 ± 0.340 ms; the left eyes 7.451 ± 0.365 ms. MDA was 0.993 ± 0.102 mm in the right eyes and 0.982 ± 0.100 mm in the left eyes. Mean HCT of the right eyes was 16.675 ± 0.502 ms; the left eyes 16.735 ± 0.555 ms. All CST parameters of both eye were remarkably symmetrical with the exception of A2L ( p = 0.006), A1DA ( p = 0.025). The majority of CST parameters of both eyes were significantly correlated with CCT and IOP ( p < 0.05). However, age, SE, and sex exert little influence on the CST measurements.

          Conclusions

          This study found interocular symmetry in corneal biomechanics in healthy children eyes. Several CST biomechanical parameters in children are modified by CCT and IOP.

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          Most cited references29

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          Determining in vivo biomechanical properties of the cornea with an ocular response analyzer.

          David Luce (2005)
          To study the results of an ocular response analyzer (ORA) to determine the biomechanical properties of the cornea and their relationship to intraocular pressure (IOP). Reichert Inc., Depew, New York, USA. The ORA (Reichert) makes 2 essentially instantaneous applanation measurements that permit determination of corneal and IOP effects. Measurements of several populations indicate that corneal hysteresis, a biomechanical measure, varied over a dynamic range of 1.8 to 14.6 mm Hg and was only weakly correlated with corneal thickness (r(2)=0.12); this is related to the observation that some subjects with relatively thick corneas have less-than-average corneal hysteresis. Corneal hysteresis changes diurnally, presumably as a result of hydration changes. Keratoconus, Fuchs' dystrophy, and post-LASIK patients demonstrated low corneal hysteresis. The corneal hysteresis biomechanical measure may prove valuable for qualification and predictions of outcomes of refractive surgery and in other cases in which corneal biomechanics are important.
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            What biomechanical properties of the cornea are relevant for the clinician?

            Although the effects of central corneal thickness and corneal curvature on intraocular pressure measurement are well known, it has only recently become possible to measure the biomechanical properties of the cornea in vivo. This article reviews the structural and material properties of the cornea and considers the effects of corneal parameters, including biomechanics, on IOP measurement. The role of corneal biomechanics as a potential indicator of the structural integrity of the globe will also be discussed. Current evidence suggests that the importance of corneal biomechanics to the glaucoma clinician rests primarily with its effects on IOP measurement. However, the possibility that corneal biomechanics may give an indication of the structural integrity of the optic nerve head cannot be completely excluded. Further population and longitudinal studies are needed to clarify whether current in vivo measures of corneal biomechanical properties, including corneal hysteresis, prove to be independent predictors of glaucoma susceptibility.
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              Collagen fibrils in the human corneal stroma: structure and aging.

              Transparency and biomechanical properties of the cornea depend on the structure and organization of collagen fibrils. The authors determined diameter, axial period, and lateral molecular spacing of collagen fibrils in human corneal stroma as a function of age. Seventeen normal human corneas were investigated in their native state by means of small-angle and wide-angle x-ray scattering. The mean radius of collagen fibrils, the axial period of collagen fibrils, and the lateral intermolecular Bragg spacing were found to be age dependent. The authors determined fibril radii of 16.1 +/- 0.5 nm in persons older than 65 years of age (n = 10) and 15.4 +/- 0.5 nm (mean +/- SD) in persons younger than 65 years (n = 7) (P 65 years) and 65.2 +/- 0.8 nm ( 65 years) and 1.499 +/- 0.013 nm (< 65 years) for the intermolecular Bragg spacing (P < 0.022). Aging is related to a three-dimensional growth of collagen fibrils in the human corneal stroma. The age-related growth of the fibril diameter was mostly a result of an increased number of collagen molecules and, in addition, to some expansion of the intermolecular Bragg spacing probably resulting from glycation-induced cross-linking. The observed expansion of the fibrils in an axial direction may result from reduction of the molecular tilting angle within collagen fibrils. The observed alterations of the collagen framework may have implications for refractive surgery and ocular tonometry achieved through related changes in the biomechanical properties of the cornea.
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                Author and article information

                Contributors
                943602453@qq.com
                wawjding@126.com
                32841542@qq.com
                20450291@qq.com
                80534643@qq.com
                86-20-87330381 , zhongxwu@mail.sysu.edu.cn
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                17 May 2017
                17 May 2017
                2017
                : 17
                : 70
                Affiliations
                [1 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, , Sun Yat-sen University, ; 54S Xianlie Road, 510060 Guangzhou, China
                [2 ]ISNI 0000 0001 2360 039X, GRID grid.12981.33, Hainan Eye Hospital, Zhongshan Ophthalmic Center, , Sun Yat-sen University, ; Haikou, China
                Author information
                http://orcid.org/0000-0001-7582-4715
                Article
                463
                10.1186/s12886-017-0463-x
                5436434
                28514942
                84545dc7-9927-4513-b9cb-7552b833e9df
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 June 2016
                : 8 May 2017
                Funding
                Funded by: Science and Technology Planning Project of Guangdong and Hainan Province
                Award ID: ZDXM2014077, 2013B090200057
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Ophthalmology & Optometry
                corvis st,corneal biomechanics,corneal deformation,symmetry,chinese,children
                Ophthalmology & Optometry
                corvis st, corneal biomechanics, corneal deformation, symmetry, chinese, children

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