ArticleAmerican journal of translational research2026
Multifactorial analysis of corneal biomechanical stability after deep anterior lamellar keratoplasty: integration of anterior segment imaging indices and ocular response analyzer data.
Article in American journal of translational research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify independent predictors of corneal biomechanical stability after deep anterior lamellar keratoplasty (DALK) by integrating anterior segment imaging indices with Ocular Response Analyzer (ORA) data.
methodsThis retrospective case-control study included 209 patients (209 eyes) with advanced-stage keratoconus who underwent DALK at HeBei Eye Hospital between January 2019 and December 2024. Patients were classified into high (n=146) and low (n=63) biomechanical stability groups based on 12-month postoperative clinical status. Preoperative findings included anterior segment imaging metrics (central corneal thickness, thinnest corneal thickness, anterior chamber depth, anterior chamber angle, maximum keratometry, central keratoconus index), ORA-derived biomechanical indices (corneal hysteresis, corneal resistance factor), and perioperative variables (residual stromal bed thickness, intraoperative complications, postoperative steroid duration).
resultsAmong the 209 enrolled patients, 146 (69.9%) achieved high biomechanical stability, while 63 (30.1%) were classified as having low biomechanical stability. Multivariate logistic regression identified six independent predictors of low biomechanical stability: higher maximum keratometry (odds ratio [OR]=1.164, P<0.001), wider anterior chamber angle (OR=1.099, P=0.004), greater residual stromal bed thickness (OR=1.044, P=0.011), occurrence of intraoperative complications (OR=3.401, P=0.020), lower preoperative corneal hysteresis (OR=0.727, P=0.008), and shorter duration of postoperative steroid use (OR=0.875, P=0.010).
conclusionsSix independent predictors of post-DALK biomechanical stability were identified, spanning preoperative, intraoperative, and postoperative factors. These findings may aid risk stratification, pending prospective validation.
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