ArticleEye and vision (London, England)2024
Keratoconus cone location influences ocular biomechanical parameters measured by the Ocular Response Analyzer.
Article in Eye and vision (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 15 citations in OpenAlex.
- Regional Biomechanical and Topographic Changes after Transepithelial vs. Epithelium-off Continuous Accelerated Corneal Cross-linking in Keratoconus: Updated Stress-Strain Index as a Superior Biomarker.Ophthalmology science · 2026Article
- Corneal biomechanical and tomographic outcomes following accelerated cross-linking in keratoconus: a focus on cone localization.Japanese journal of ophthalmology · 2026Article
- Adaptive Temporal Mixture of Experts for Predicting Stiffness Metrics From the Ocular Response Analyzer and Identifying Keratoconus.American journal of ophthalmology · 2026Observational
- Regional corneal biomechanics assessment as a function of age using Strain-Stress Index maps.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Review
- Nanoindentation under retrocorneal pressure to determine the biomechanical response of the human cornea to accelerated UVA crosslinking and riboflavin osmolarity ex vivo.Scientific reports · 2025Article
- Waveform Score Influences the Outcome Metrics of the Ocular Response Analyzer in Patients with Keratoconus and in Healthy Controls.Current eye research · 2025Article
- A Novel Approach to Fabricate Early Keratoconus Phantom Models.Translational vision science & technology · 2025Article
- A novel corneal indentation device for comparison of corneal tangent modulus before and after FS-LASIK in vivo.Biomedical engineering online · 2025Article
- Corneal biomechanical properties in myopic anisometropia measured by corneal visualization scheimpflug technology.American journal of translational research · 2025Article
- Intraocular pressure and ocular biomechanical parameters vary between generations of the ocular response analyzer in healthy and ectatic eyes.Frontiers in medicine · 2025Article
- Clinical outcomes of two symmetrical Kera-rings implanted in grade three keratoconus: a retrospective nonrandomized study.BMC ophthalmology · 2024Article
- Eccentric Pathology in Keratoconus Exhibits Stiffer Biomechanical Response than Central Pathology.Ophthalmology scienceArticle
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundKeratoconus is characterized by asymmetry in the biomechanical properties of the cornea, with focal weakness in the area of cone formation. We tested the hypothesis that centrally-measured biomechanical parameters differ between corneas with peripheral cones and corneas with central cones.
methodsFifty participants with keratoconus were prospectively recruited. The mean ± standard deviation age was 38 ± 13 years. Axial and tangential corneal topography were analyzed in both eyes, if eligible. Cones in the central 3 mm of the cornea were considered central, and cones outside the central 3 mm were considered peripheral. Each eye was then measured with the Ocular Response Analyzer (ORA) tonometer. T-tests compared differences in ORA-generated waveform parameters between cohorts.
resultsSeventy-eight eyes were analyzed. According to the axial topography maps, 37 eyes had central cones and 41 eyes had peripheral cones. According to the tangential topography maps, 53 eyes had central cones, and 25 eyes had peripheral cones. For the axial-topography algorithm, wave score (WS) was significantly higher in peripheral cones than central cones (inter-cohort difference = 1.27 ± 1.87). Peripheral cones had a significantly higher area of first peak, p1area (1047 ± 1346), area of second peak, p2area (1130 ± 1478), height of first peak, h1 (102 ± 147), and height of second peak, h2 (102 ± 127), than central cones. Corneal hysteresis (CH), width of the first peak, w1, and width of the second peak, w2, did not significantly differ between cohorts. There were similar results for the tangential-topography algorithm, with a significant difference between the cohorts for p1area (855 ± 1389), p2area (860 ± 1531), h1 (81.7 ± 151), and h2 (92.1 ± 131).
conclusionsCone location affects the biomechanical response parameters measured under central loading of the cornea. The ORA delivers its air puff to the central cornea, so the fact that h1 and h2 and that p1area and p2area were smaller in the central cone cohort than in the peripheral cone cohort suggests that corneas with central cones are softer or more compliant centrally than corneas with peripheral cones, which is consistent with the location of the pathology. This result is evidence that corneal weakening in keratoconus is focal in nature and is consistent with localized disruption of lamellar orientation.
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