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

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          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).


          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.


          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.


          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 references 29

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

           D Luce (2004)
          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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            Correlations between corneal hysteresis, intraocular pressure, and corneal central pachymetry.

            To analyze the correlation between corneal hysteresis (CH) measured with the Ocular Response Analyzer (ORA, Reichert) and ultrasonic corneal central thickness (CCT US) and intraocular pressure measured with Goldmann applanation tonometry (IOP GA). Bordeaux 2 University, Ophthalmology Department, Bordeaux, France. This study comprised 498 eyes of 258 patients. Corneal hysteresis, corneal resistance factor (CRF), and IOP corneal-compensated (IOPcc) were provided by the ORA device; CCT US and IOP GA were also measured in each eye. The study population was divided into 5 groups: normal (n = 122), glaucoma (n = 159), keratoconus (n = 88), laser in situ keratomileusis (LASIK) (n = 78), and photorefractive keratectomy (n = 39). The Pearson correlation was used for statistical analysis. Corneal hysteresis was not strongly correlated with IOP or CCT US. The mean CH in the LASIK (8.87 mm Hg) and keratoconus (8.34 mm Hg) groups was lower than in the glaucoma (9.48 mm Hg) and normal (10.26 mm Hg) groups. The lower the CH, the lower its correlation with IOPcc and IOP GA. A CH higher than the CRF was significantly associated with the keratoconus and post-LASIK groups. Corneal hysteresis, a new corneal parameter, had a moderate dependence on IOP and CCT US. Weaker corneas could be screened with ORA parameters, and low CH could be considered a risk factor for underestimation of IOP. The CCT US should continue to be considered a useful parameter.
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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.

                Author and article information

                86-20-87330381 , zhongxwu@mail.sysu.edu.cn
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                17 May 2017
                17 May 2017
                : 17
                [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
                © 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.

                Funded by: Science and Technology Planning Project of Guangdong and Hainan Province
                Award ID: ZDXM2014077, 2013B090200057
                Award Recipient :
                Research Article
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                © The Author(s) 2017

                Ophthalmology & Optometry

                corvis st, corneal biomechanics, corneal deformation, symmetry, chinese, children


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