Abstract
Background and Objectives: There is a clear evidence that pregnancy is associated with high production of sex hormones. During the first, second and third trimester of pregnancy, blood hormones levels increase gradually. Cells with affinity for sex hormones have been identified in different ocular tissues, such as: lid, lacrimal gland, meibomian gland, bulbar and palpebral conjunctivae, cornea, iris, ciliary body, lens, retina (retinal pigment epithelium) and choroid. This is why pregnancy is associated with changes at ocular level, involving anterior and posterior segments. Several clinical trials have been made trying to highlight changes in corneal biomechanics during pregnancy. By conducting this review, we want to evaluate both the changes in parameters that define corneal biomechanics and intraocular pressure values in pregnant. Materials and Methods: Following a systematic search in the literature related mainly to changes in corneal biomechanics during pregnancy, focusing on the paper published in the last decade, we included in a meta-analysis the cumulative results of three prospective comparative studies. Results: Important changes in corneal biomechanics (corneal hysteresis and corneal resistance factor) parameters were observed in women in the third trimester of pregnancy, but these variations were not statistically significant. Also, a decrease in intraocular pressure was mentioned in these women, but only the corneal compensation intraocular pressure showed a decrease with statistical significance. Conclusions: A decrease in corneal compensatory intraocular pressure was observed in pregnant women in the third trimester of pregnancy, but without other statistically significant changes resulting from the analysis of the other three parameters (corneal hysteresis, corneal resistance factor and Goldmann-correlated intraocular pressure).
Highlights
The literature search resulted in 108 articles related to corneal biomechanics during pregnancy
One trial had no control group, while another one had no specific data related to pregnancy age, so these two trials were excluded from the data analysis
In the meta-analysis performed by entering all the statistical data from three clinical trials, a statistically significant value was noted for the IOPcc parameter, resulting in a decrease in corneal compensation intraocular pressure in the third trimester of pregnancy between 0.08 mmHg and 1.30 mmHg, averaging 0.69 mmHg
Summary
Starting with the second trimester of pregnancy, the anatomical changes are caused by the mechanical action of the uterus, while the variation in sex hormone concentrations becomes much more significant [1]. These actions are completely physiological and most commonly involve multiple organs, including the eyes [2,3]. Cells with affinity for sex hormones have been identified in different ocular tissues, such as: lid, lacrimal gland, meibomian gland, bulbar and palpebral conjunctivae, cornea, iris, ciliary body, lens, retina (retinal pigment epithelium) and choroid This is why pregnancy is associated with changes at ocular level, involving anterior and posterior segments. Results: Important changes in corneal biomechanics (corneal hysteresis and corneal resistance factor) parameters were observed in women in the third trimester of pregnancy, but these variations were not statistically significant
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