Abstract
PURPOSE: The purpose of this study was to investigate the influence of corneal diameter (CD) on corneal biomechanics and biometry parameters to allow more accurate evaluation of refractive surgery patients. METHODS: In this cross-sectional study, 203 Chinese participants were categorized into four groups based on CD (group A = CD ≤11.1 mm, group B = CD = 11.2-11.5 mm, group C = CD = 11.6-12 mm, and group D = CD >12.0 mm). Data collected included age, gender, intraocular pressure, spherical equivalent, and parameters from the Pentacam and Corvis ST. Statistical analysis was performed using SPSS software. RESULTS: The study included 203 eyes. For the Pentacam examination, corneal curvature, thinnest pachymetry (TP), back elevations (BEs), corneal elevation difference (front and back), pachymetry progression indices (PPIs), index of surface variance (ISV), keratoconus percentage index (KISA%), and most of the Belin/Ambrósio Enhanced Ectasia Display (BAD) parameters were negatively correlated with CD (linear regression analysis, P < 0.05). The abnormal rate of Pentacam parameters in the CD ≤11.1 mm group was higher than other groups. For Corvis ST, CD was positively correlated with peak distance (PD) and Ambrósio relational thickness to the horizontal profile (Arth), but negatively correlated with tomographic and biomechanical index (TBI) and Corvis biomechanical index (CBI; linear regression analysis, P < 0.05). The CD ≤11.1 mm group demonstrated the highest CBI and TBI values, although these parameters remained within the normal range. CONCLUSIONS: Corneal diameter significantly influences Pentacam and Corvis ST parameters, particularly on BE, BAD-D, PPIs, CBI, and TBI. TRANSLATIONAL RELEVANCE: Incorporating corneal diameter into preoperative screening may help improve the specificity of keratoconus detection and reduce unnecessary exclusion of eligible refractive surgery candidates with small corneas.