ABSTRACT.Purpose: To determine whether corneal hysteresis (CH) and corneal resistance factor (CRF) are altered in diabetes and whether these parameters are related to HbA1c. Methods: One randomly chosen eye of 35 healthy subjects and 31 patients with diabetes was examined. Patients with diabetes were divided into group 1 with HbA1c <7% (n = 14) and group 2 with HbA1c ‡7% (n = 17). CH and CRF were measured using ocular response analyzer (ORA); central corneal thickness (CCT) using ultrasound pachymetry; increased intraocular pressure (IOP) using Goldmann tonometer (IOP GAT ), Pascal dynamic contour tonometer (IOP pasc ), and ORA (IOP cc ). As CH and CRF are dependent on IOP and CCT, they were adjusted for IOP and CCT resulting in CH corr and CRF corr. Results: Mean HbA1c was 5.44 ± 0.46% in healthy subjects, 6.00 ± 0.78% in diabetic group 1, 8.58 ± 2.44% in group 2. CH corr (p = 0.071) and CRF corr (p = 0.067) were not statistically significantly different between healthy subjects and diabetic group 1, but significantly lower in healthy subjects compared to diabetic group 2 [CH corr (p = 0.031), CRF corr (p = 0.029)]. IOP pasc (p = 0.012), IOP GAT (p = 0.032) and HbA1c (p = 0.0001) were statistically significantly different between healthy subjects and all patients with diabetes (groups 1 + 2), but not age, sex and CCT. Over all patients with diabetes, CH corr (p = 0.012, R 2 = 0.197) and CRF corr (p = 0.008, R 2 = 0.217) were correlated to HbA1c but not in healthy subjects [CH corr (p = 0.931, R 2 = 0.0001), CRF corr (p = 0.837, R 2 = 0.001)]. Conclusion: In poorly controlled diabetics, CH corr and CRF corr are significantly higher compared with those of the healthy subjects and patients with well-controlled diabetes. In diabetes, CH corr and CRF corr are correlated to HbA1c, suggesting that the biomechanical properties of the cornea are altered depending on the glucose control.
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