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Updated: Aug 1, 2025

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Effect of corneal stiffness decrease on axial length elongation in myopia determined based on a mathematical

Qi Ren1,2,3, Zhe Chu1,2,3, Wei Cui1,2,3

  • 1Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China.

Frontiers in Bioengineering and Biotechnology
|April 27, 2023
PubMed
Summary
This summary is machine-generated.

Axial length (AL) elongation in myopia is linked to decreased corneal stiffness, measured by the stress-strain index (SSI). Lower SSI values correlate with longer AL, suggesting a relationship between corneal biomechanics and myopia progression.

Keywords:
axial lengthdynamic corneal responsemyopiaspherical equivalent errorstress-strain index

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Area of Science:

  • Ophthalmology
  • Biomechanical Engineering
  • Myopia Research

Background:

  • Myopia is a growing public health concern, often associated with axial length (AL) elongation.
  • Corneal material properties, such as stiffness, may play a role in ocular development and refractive error progression.
  • The stress-strain index (SSI) is a parameter reflecting corneal stiffness.

Purpose of the Study:

  • To investigate the relationship between corneal stiffness (SSI) and axial length (AL) elongation in myopia.
  • To explore how varying severities of myopia influence the association between SSI and AL.
  • To utilize a mathematical estimation model to analyze these biomechanical and ocular parameters.

Main Methods:

  • A cross-sectional study involving healthy subjects and those undergoing refractive surgery.
  • Development and validation of an estimated AL model based on established mathematical equations.
  • Proposal of an axial increment model linked to spherical equivalent error (SER) and real AL.
  • Evaluation of SSI variations in relation to AL and myopia severity using mathematical models.

Main Results:

  • Axial length (AL) showed a strong positive association with an estimated parameter (r=0.91, p<0.001).
  • Spherical equivalent error (SER) was negatively associated with the same parameter (r=-0.89, p<0.001).
  • The stress-strain index (SSI) was negatively associated with AL (β=-2.01, p<0.001) and positively with SER (β=0.48, p<0.05).
  • In subjects with AL ≥ 26 mm, SSI was negatively associated with the estimated parameter (β=-1.36, p=0.02).

Conclusions:

  • Axial length (AL) increases as corneal stiffness (SSI) decreases in myopic individuals.
  • Corneal biomechanical properties, specifically reduced stiffness, are associated with longer axial lengths in myopia.
  • These findings suggest a potential link between corneal material properties and the progression of myopia.