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

Abstract

Purpose: To investigate the relationship between the corneal material stiffness parameter stress-strain index (SSI) and axial length (AL) elongation with varying severities of myopia, based on a mathematical estimation model. Methods: This single-center, cross-sectional study included data from healthy subjects and patients preparing for refractive surgery in the Qingdao Eye Hospital of Shandong First Medical University. Data were collected from July 2021 to April 2022. First, we performed and tested an estimated AL model ((Formula presented.)) based on the mathematical equation proposed by Morgan. Second, we proposed an axial increment model ((Formula presented.)) corresponding to spherical equivalent error (SER) based on (Formula presented.) ((Formula presented.) at SER = 0) and subject’s real AL. Finally, we evaluated the variations of (Formula presented.) with SSI changes based on the mathematical estimation model. Results: We found that AL was closely associated with (Formula presented.) (r = 0.91, t = 33.8, p < 0.001) with good consistency and SER was negatively associated with (Formula presented.) (r = −0.89, t = −30.7, p < 0.001). The association of SSI with AL, (Formula presented.), and (Formula presented.) can be summarized using the following equations: (Formula presented.), (Formula presented.), and (Formula presented.). In adjusted models, SSI was negatively associated with AL (Model 1: β = −2.01, p < 0.001) and (Formula presented.) (Model 3: β = −2.49, p < 0.001) but positively associated with (Formula presented.) (Model 2: β = 0.48, p < 0.05). In addition, SSI was negatively associated with (Formula presented.) among subjects with AL ≥ 26 mm (β = −1.36, p = 0.02). Conclusion: AL increased with decreasing SSI in myopia.