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. 2023 Jun 1:11:1163223.
doi: 10.3389/fbioe.2023.1163223. eCollection 2023.

Comparison of bilateral differential characteristics of corneal biomechanics between keratoconus and normal eyes

Yiyong Xian  1   2   3   4 , Yu Zhao  1   2   3   4 , Ling Sun  1   2   3   4 , Xiaoyu Zhang  1   2   3   4 , Lan Ding  1   2   3   4 , Zesheng Liu  1   2   3   4 , Yuan Li  5 , Yanlan Ding  1   2   3   4 , Lin Jiang  1   2   3   4 , Xingtao Zhou  1   2   3   4 , Yang Shen  1   2   3   4
Affiliations

Comparison of bilateral differential characteristics of corneal biomechanics between keratoconus and normal eyes

Yiyong Xian et al. Front Bioeng Biotechnol. .

Abstract

Purpose: To compare bilateral differences in corneal biomechanics between keratoconus and normal eyes. Methods: In this case-control study, 346 eyes of 173 patients (aged 22.1 ± 6.1 years) with keratoconus (KC group) and 378 eyes of 189 patients (aged 26.7 ± 5.6 years) with ametropia (control group) were enrolled. Corneal tomography and biomechanical properties were examined using Pentacam HR and Corvis ST, respectively. The corneal biomechanical parameters were compared between eyes with forme fruste keratoconus (FFKC) and normal eyes. Bilateral differences in corneal biomechanical parameters were compared between the KC and control groups. Receiver operating characteristic (ROC) analysis was used to assess discriminative efficacies. Results: The areas under the ROC curves (AUROCs) of stiffness parameter at the first applanation (SP-A1) and Tomographic and Biomechanical Index (TBI) for identifying FFKC were 0.641 and 0.694, respectively. The bilateral differential values of major corneal biomechanical parameters were significantly increased in the KC group (all p < 0.05), except for the Corvis Biomechanical Index (CBI). The AUROCs of the bilateral differential values of the deformation amplitude ratio at 2 mm (ΔDAR2), Integrated Radius (ΔIR), SP-A1 (ΔSP-A1), and the maximum inverse concave radius (ΔMax ICR) for discriminating keratoconus were 0.889, 0.884, 0.826, and 0.805, respectively. The Logistic Regression Model-1 (comprising of ΔDAR2, ΔIR, and age) and the Logistic Regression Model-2 (comprising of ΔIR, ΔARTh, ΔBAD-D, and age) had AUROCs of 0.922 and 0.998, respectively, for discriminating keratoconus. Conclusion: The bilateral asymmetry of corneal biomechanics was significantly increased in keratoconus compared with normal eyes, which may be helpful for the early detection of keratoconus.

Keywords: biomechanics; corneal ectasia; forme fruste keratoconus; keratoconus; tomography; topography.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Bilateral differences of corneal biomechanics and tomography in a patient with keratoconus.
FIGURE 2
FIGURE 2
Receiver operating characteristic curves of major bilateral differential parameters, ΔDAR2 (asymmetry of the deformation amplitude ratio at 2 mm), ΔIR (asymmetry of Integrated Radius), ΔMax ICR (asymmetry of the maximum inverse concave radius), ΔSP-A1 (asymmetry of the stiffness parameter at the first applanation), and ΔBAD-D (asymmetry of the Belin/Ambrosio Enhanced Ectasia Deviation value), for keratoconus versus the control group.
FIGURE 3
FIGURE 3
Receiver operating characteristic curves of two multivariable classification models, the Logistic regression model-1 (LRM-1), and Logistic regression model-2 (LRM-2) for keratoconus versus the control group.
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