ArticleOphthalmology science
Corneal Stress Distribution Evolves from Thickness-Driven in Normal Corneas to Curvature-Driven with Progression in Keratoconus.
Article in Ophthalmology science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 19 citations in OpenAlex.
- The Science and Clinical Evolution of Corneal Cross-Linking: Mechanism of Action, Ultra-Structural Changes, Clinical Indications, and Emerging Treatment Strategies.Ophthalmology and therapy · 2026Review
- Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care.Ophthalmology and therapy · 2026Review
- Motion-Tracking Brillouin Microscopy for Keratoconus Suspect Identification: Comparison With Multimodal Corneal Imaging.American journal of ophthalmology · 2026Article
- Corneal Cross-Linking Induces Increased Corneal Refractive Index, Which Generates Measurement Error of Central Corneal Thickness.Ophthalmology science · 2026Article
- Waveform Score Influences the Outcome Metrics of the Ocular Response Analyzer in Patients with Keratoconus and in Healthy Controls.Current eye research · 2025Article
- Technical report: Calculation and interpretation of corneal transference maps.Optometry and vision science : official publication of the American Academy of Optometry · 2025Article
- Correlations of anterior and posterior corneal parameters in Chinese myopic patients: a retrospective multicenter study.Quantitative imaging in medicine and surgery · 2025Article
- The Contribution of the Limbus and Collagen Fibrils to Corneal Biomechanical Properties: Estimation of the Low-Strain In Vivo Elastic Modulus and Tissue Strain.Biomimetics (Basel, Switzerland) · 2024Article
- Determining the Relationship Between Corneal Stiffening and Tissue Dehydration After Corneal Cross-Linking.Investigative ophthalmology & visual science · 2024Article
- Squishy matters - Corneal mechanobiology in health and disease.Progress in retinal and eye research · 2024Review
- Keratoconus cone location influences ocular biomechanical parameters measured by the Ocular Response Analyzer.Eye and vision (London, England) · 2024Article
- Focal Weakening/Thinnest Corneal Point Proximity in Normal, Subclinical, and Keratoconic Corneas Using Motion-Tracking Brillouin Microscopy.Ophthalmology scienceArticle
- From CLMI.X to CLMIX-AI: A Machine Learning-Based Upgrade of the Cone Location and Magnitude Index Expanded to Detect Keratoconus Suspects.Ophthalmology scienceArticle
- Brillouin microscopy for focal biomechanical measurements in normal and keratoconic corneas: A narrative review.Survey of ophthalmologyReview
- Eccentric Pathology in Keratoconus Exhibits Stiffer Biomechanical Response than Central Pathology.Ophthalmology scienceArticle
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
Purpose: To introduce the novel parameter of Corneal Contribution to Stress (CCS) and compare stress distribution patterns between keratoconus (KCN) and normal corneas. Design: Prospective, observational, cross-sectional study. Participants: The study included 66 eyes of 40 subjects diagnosed with KCN and 155 left eyes from 155 normal control (NRL) subjects. Methods: Tomography was obtained to calculate the newly proposed CCS, defined according to the hoop stress formula without intraocular pressure, R/2t, where R is the radius of curvature and t is the thickness. CCS maps were calculated from pachymetry and tangential curvature maps. Custom software identified the 2-mm-diameter zones of greatest curvature (Cspot-max), thinnest pachymetry (Pach-min), greatest stress (CCSmax), and lowest stress (CCSmin). Stress difference (CCSdiff) was calculated as CCSmax - CCSmin. Distances between Cspot-max vs. Pach-min, vs. CCSmax, and vs. CCSmin, as well as between Pach-min vs. CCSmax and vs. CCSmin, were calculated. Main Outcome Measures: Corneal stress parameters, corneal features of maximum curvature, minimum thickness, and distances between corneal stress parameters and corneal features. Results: CCSmax was significantly closer to Pach-min (0.79 ± 0.92) and Cspot-max (2.04 ± 0.85) than CCSmin (3.17 ± 0.38, 2.73 ± 1.53, respectively) in NRL, Conclusions: Corneal stress is driven by thickness in NRL, with greatest stress at thinnest pachymetry and greatest curvature. However, maximum stress moves away from thinnest pachymetry with progression in KCN, and Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Registered trials
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