Cornea biomechanical characteristics and their correlates with refractive error in Singaporean children.
OBJECTIVE
To determine corneal biomechanical parameters measured with the Reichert Ocular Response Analyser (ORA) in Singaporean children, and to assess their possible correlations with refractive error and biometry.


METHODS
This was a cross-sectional study of 271 subjects from the Singapore Cohort Study of Risk Factors for Myopia (SCORM). Corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), and cornea-compensated intraocular pressure (IOPcc) were measured with the ORA. Spherical equivalent refraction was assessed with an autokeratorefractometer and axial length by contact ultrasound A-scan biometry. Height, weight, and blood pressure were measured.


RESULTS
The mean age of the study population was 13.97 +/- 0.89 years, the distribution of the sexes was almost equal (138 boys, 50.9%), and most were Chinese (186 subjects, 68.6%). The mean (+/-SD) CH and CRF were 11.78 +/- 1.55 (range, 6.93-16.53) and 11.81 +/- 1.71 (range, 7.83-16.83) mm Hg. CH and CRF did not vary significantly with age (P = 0.24; 0.61), sex (P = 0.21; 0.08), or race (P = 0.23; 0.36). CH and CRF did not vary with myopia status (P = 0.79; 0.83) or axial length (Pearson correlation coefficient [r] = -0.11 and -0.05, P = 0.08 and 0.40). Multivariate analyses were performed with CH, CRF, or CCT as the dependent variable and age, sex, race, weight, IOPcc, CCT, SE refraction, and corneal curvature as covariates. CH was significantly associated with IOP (regression coefficients [beta] = -0.22 [95% confidence interval = -0.27 to -0.17]), CCT (beta = 0.03 [0.02-0.03]) and corneal curvature (beta = -1.13 [-2.08 to -0.19]). CRF was significantly associated with IOP, CCT, and corneal curvature (beta = 0.08 [0.02-0.14]; 0.03 [0.03-0.04], and -1.39 [-2.54 to -0.23], respectively). The only factor that was predictive of decreased CCT was Malay or Indian race (P = 0.03 and <0.001), compared with Chinese.


CONCLUSIONS
The CH and CRF values in our study on Singaporean children are slightly higher than in adult studies. CH and CRF are not associated with refractive error or axial length. Flatter corneas are associated with lower CH and CRF readings.
Lim
Laurence
L
Singapore Eye Research Institute, Singapore.
Gazzard
Gus
G
Chan
Yiong-Huak
YH
Fong
Allan
A
Kotecha
Aachal
A
Sim
Ee-Ling
EL
Tan
Donald
D
Tong
Louis
L
Saw
Seang-Mei
SM
D000293:Adolescent; D001331:Automation; D001696:Biomechanical Phenomena; D001767:Blinking / Q000502:physiology; D002648:Child; D003315:Cornea / Q000033:anatomy & histology* / Q000502:physiology* / Q000503:physiopathology*; D003316:Corneal Diseases / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009798:Ocular Hypertension / Q000503:physiopathology; D012030:Refractive Errors / Q000453:epidemiology / Q000503:physiopathology*; D012846:Singapore