Corneal Biomechanical Changes in Diabetes Mellitus and Their Influence on Intraocular Pressure Measurements

Abstract

PURPOSE: To investigate possible corneal biomechanical changes in patients with diabetes mellitus and understand the influence of such changes on intraocular pressure measurements. METHODS: The study group was composed of 120 eyes from 61 healthy control subjects and 81 eyes from 43 diabetic subjects. IOP was measured first with an ocular response analyzer (ORA) and subsequently with a Goldmann applanation tonometer (GAT). Central corneal thickness (CCT) was measured with an ultrasonic pachymeter attached to the ORA. Axial length (AL), anterior chamber depth (ACD), and keratometry readings were acquired with partial coherence laser interferometry during the same visit before all IOP and CCT determinations were made. RESULTS: Corneal hysteresis (CH) was found to be significantly lower in diabetic patients when compared with healthy control subjects (9.51 +/- 1.82 mm Hg vs. 10.41 +/- 1.66 mm Hg, P < 0.0001). There was no significant difference in terms of corneal resistance factor (CRF; P = 0.8). Mean CCT, GAT IOP, Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were significantly higher in diabetic patients than in healthy control subjects (P = 0.01 for CCT, P < 0.0001 for GAT IOP, IOPg, and IOPcc). CONCLUSIONS: Diabetes affects corneal biomechanics and results in lower CH values than those in healthy control subjects, which may cause clinically relevant high IOP measurements independent of CCT.