Changes in corneal biomechanics in patients with diabetes mellitus: a systematic review and meta-analysis.

Abstract

To determine the changes in corneal biomechanical parameters in patients with diabetes mellitus (DM) in comparison with controls. Pertinent studies were identified by comprehensively search of PubMed, Embase, the Web of Science, the Cochrane Library, Scopus, the China National Knowledge Infrastructure and the Chinese biomedical disc (CBM) databases. Pooling analyses by random models using the D-L method were performed for corneal hysteresis (CH), the corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg). A total of 15 studies were included in the final analysis, involving 1506 eyes in the diabetic group and 2190 eyes in the control group. The diabetic group had significantly higher CH, CRF, IOPg and IOPcc values than the control group. The pooled mean differences were 1.34mmHg (95% confidence interval [CI] 0.60-2.08mmHg, P < 0.001) for IOPg and 0.85mmHg (95% CI 0.18-1.51mmHg, P = 0.013) for IOPcc, 0.38mmHg (95% CI 0.01-0.75, P = 0.047) for CH and 0.63mmHg (95% CI 0.27-0.98, P = 0.001) for the CRF. Sensitivity analyses using the leave-one-out method showed a consistent significant difference between the groups (all P < 0.001). Corneal biomechanics changed in the patients with DM. High CH, CRF, IOPcc and IOPg values may be associated factors for diabetes mellitus. Future studies are warranted to clarify the underlying mechanisms and explore the relationship between corneal biomechanics, glaucoma and diabetes mellitus. PROSPERO registration No CRD4201705465.