Corneal Alterations Research Articles

Corneal alterations in eyelid diseases

Corneal changes associated with eyelid disease are frequent and can considerably complicate the course of the disease. They can manifest as refraction anomalies, corneal degeneration, ocular surface disease, corneal infiltrates, corneal vascularization and corneal ulceration up to corneal perforation. Pathophysiologically relevant are compressive forces, exposure, trichiasis and distichiasis, eye rubbing, inflammation and infection. Amultitude of eyelid diseases is associated with diseases of the cornea including eyelid malposition, eyelid tumors, eyelid infections, allergic eyelid dermatitis, blepharitis, meibomitis, and Meibomian gland disease.

Evaluation of Visual Acuity Outcomes and Corneal Alterations of New Generation Hybrid Contact Lenses in Patients With Advanced Keratoconus.

To evaluate the visual and corneal outcomes of new generation hybrid contact lenses (HCL) in patients with advanced keratoconus. This was a retrospective study undertaken at a single academic center. The study cohort consisted of subjects with advanced keratoconus who had elected not to undergo keratoplasty and were fitted with HCLs. Patients were fitted either with EyeBrid (LCS, Cane, France) or Airflex (SwissLens, Prilly, Switzerland) HCLs. Primary outcome measures included contact lens (CL) drop-out rate, best corrected visual acuity, and corneal endothelial cell density (ECD) measurements at the end of a 6-month HCL wear. ECD was measured using in vivo confocal microscopy (ConfoScan4; Nidek, Tokyo, Japan). One eye per patient was included for statistical purposes. Paired t tests and Wilcoxon signed-rank tests were used for comparative analyses. Thirty-two keratoconic eyes of 32 patients (14M/18F) with a mean age of 25.9 ± 11.5 years were included in the study. All patients were able to continue CL wear for a duration of 6 months. There was a significant improvement in the mean best corrected visual acuity from 0.5 ± 0.2 logarithm of minimal angle of resolution to 0.1 ± 0.1 logarithm of minimal angle of resolution after daily CL wear with HCL at the 6-month follow-up visit (P < 0.001). No vision-threatening CL-related corneal adverse effects were observed. There was no significant reduction in the ECD noted at the 6-month visit [2625.8 ± 300.3 cells/mm (baseline) vs. 2566.4 ± 309.8 cells/mm (6-month); P = 0.623]. Hybrid contact lenses can provide improved visual function without inducing any short-term clinical or microscopic adverse effects on corneal endothelial cells in patients with advanced keratoconus.

An Assay System to Evaluate Riboflavin/UV-A Corneal Phototherapy Efficacy in a Porcine Corneal Organ Culture Model.

Simple summaryThe scope of this study is to quantitatively evaluate, with an automated digital image analysis method, the efficacy of riboflavin/UV-A corneal phototherapy on the cornea in a porcine corneal organ culture model of ulcerative melting keratitis. Riboflavin/UV-A corneal phototherapy provided a favorable outcome in the corneal wound healing process after chemical injury: the treatment restores the damaged corneas to the texture of healthy corneas. This automated image analysis method may be compared to clinical diagnostic methods, such as optical coherence tomography (OCT) imaging, for in vivo damaged ocular structural investigations. Positive results from this research could provide an opportunity for studying the effects of this method in other economically and emotionally valued species, such as dogs, cats, and horses. The relatively overall low treatment cost and the ease of performing the procedure make riboflavin/UV-A corneal phototherapy accessible to the veterinary market.The purpose of this study was to investigate the response of porcine corneal organ cultures to riboflavin/UV-A phototherapy in the injury healing of induced lesions. A porcine corneal organ culture model was established. Corneal alterations in the stroma were evaluated using an assay system, based on an automated image analysis method able to (i) localize the holes and gaps within the stroma and (ii) measure the brightness values in these patches. The analysis has been performed by dividing the corneal section in 24 regions of interest (ROIs) and integrating the data analysis with a “multi-aspect approach.” Three group of corneas were analyzed: healthy, injured, and injured-and-treated. Our study revealed a significant effect of the riboflavin/UV-A phototherapy in the injury healing of porcine corneas after induced lesions. The injured corneas had significant differences of brightness values in comparison to treated (p < 0.00) and healthy (p < 0.001) corneas, whereas the treated and healthy corneas showed no significant difference (p = 0.995). Riboflavin/UV-A phototherapy shows a significant effect in restoring the brightness values of damaged corneas to the values of healthy corneas, suggesting treatment restores the injury healing of corneas after lesions. Our assay system may be compared to clinical diagnostic methods, such as optical coherence tomography (OCT) imaging, for in vivo damaged ocular structure investigations.

Corneal Biomechanical Response Alteration After Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment

To compare the corneal biomechanics of eyes that underwent scleral buckle (SB) for rhegmatogenous retinal detachment (RRD) with those of fellow eyes (fellow eyes) and to further investigate the effects of SB on intraocular pressure (IOP) values. Retrospective, fellow-eye matched cohort study. A total of 18 consecutive patients (11 males and 7 females) treated with SB for RRD in 1 eye were enrolled. Goldmann applanation tonometry was used to measure IOP. Biomechanical properties of the cornea were investigated by using the Ocular Response Analyzer (ORA) (Reichert Instruments) for the calculation of corneal resistant factor (CRF), corneal hysteresis, Goldmann-correlated IOP, and corneal-compensated IOP. Customized software was used for analysis of the ORA infrared and pressure signals, and a significance threshold was set to a P value of .05. Operated eyes (OEs) showed significantly lower values of corneal hysteresis and CRF than fellow eyes (9.0 ± 1.8 vs 10.1 ± 1.8mm Hg, respectively; P < .001; 10.0 ± 2.2 vs 10.9 ± 2.2mm Hg; P < .001). GAT was significantly lower than corneal-compensated IOP in OEs (18.1 ± 4.9 vs 19.8 ± 4.8mm Hg, respectively; P= .022) but not in fellow eyes. The second applanation event (A2) took place earlier in time, and the cornea was moving faster during A2 in the OEs than in the fellow eyes. SB for the treatment of RRD affects corneal biomechanical response, likely due to a less compliant sclera that limits corneal motion and reduces energy dissipation, reflected in a lower corneal hysteresis. This has potentially meaningful clinical implications as the accuracy of the measurement of IOP values may be affected in these eyes.

Pupil Diameter, Corneal Thickness, and Anterior Chamber Alterations Following Topical Olopatadine Hydrochloride 0.1%: A Single-Masked Randomized Controlled Clinical Study.

Purpose: Olopatadine hydrochloride 0.1% is one of the known primary topical treatments in ocular allergy. Although olopatadine is a worldwide used medication, the changes in pupil diameter, cornea, and anterior chamber associated with its use have not been studied in detail. In this prospective study, we aimed to determine the amount of mydriasis and explore the possible corneal and anterior chamber alterations after 0.1% topical olopatadine. Methods: A total of 77 eyes from 77 ocular-allergy diagnosed patients between 18 and 40 years were investigated in this prospective study. Thirty-nine eyes of 39 patients received topical olopatadine, and 38 eyes of 38 patients received sterile distilled water, randomly. Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) topography was used to assess the pupil and anterior chamber measurements at baseline and after 45 min of olopatadine or sterile distilled water instillation. Results: The differences between the baseline and 45th-min measurements for corneal thickness, anterior chamber depth, angle, and volume did not reach a statistical significance in the olopatadine or control groups. The pupil diameter significantly increased from 3.19 ± 0.62 to 3.36 ± 0.62 mm in the olopatadine group (P < 0.001), and remained relatively unchanged in the control group (P = 0.06). Conclusion: Olopatadine 0.1% does not lead to a significant change in corneal topography or anterior chamber parameters. However, it causes a slight but statistically significant increase in pupil diameter.

Corneal Epithelial "Neuromas": A Case of Mistaken Identity?

:Laser scanning in vivo confocal microscopy is a useful clinical tool to assess the corneal nerves in human and laboratory animals. With this new technology, the use of terms such as “neuromas” and “microneuromas” is becoming popular to describe nerve structures seen in humans. Here, we point out that the sites where stromal nerves enter the corneal epithelium are often hyperreflective and can appear dysmorphic when imaged using in vivo confocal microscopy. Furthermore, we clarify what is known anatomically about how the nerves enter the corneal epithelium from the stroma, and we urge colleagues to differentiate between hyperreflective foci at the corneal stromal–epithelial nerve penetration sites and alterations in nerve morphology secondary to injury or disease.

Rapid and Accurate Pressure Sensing Device for Direct Measurement of Intraocular Pressure.

PurposeIntraocular pressure (IOP) is the primary modifiable risk factor for glaucoma. Current devices measure IOP via the dynamic response of the healthy cornea and do not provide the accurate IOP measurements for patients with altered corneal biomechanics. We seek to develop and test an accurate needle-based IOP measurement device that is not cornea dependent.MethodsOur device combines a high-resolution pressure microsensor with 30- and 33-gauge Luer lock needles to provide IOP measurements via a microcontroller and USB interface to a computer. The device was calibrated in a membrane chamber and then tested and validated in the anterior chamber and post-vitrectomy vitreous chamber of rabbit eyes. The results were compared to Tonopen readings across a pressure range of 0 to 100 mm Hg, imposed in increments of 10 mm Hg.ResultsBoth the needle based sensor device and the Tonopen demonstrated a linear relationship with changes in imposed pressure. The Tonopen was found to consistently underestimate the IOP both in the anterior and vitreous chambers. The Tonopen exhibited a significantly greater error than our needle-based sensor device. With increased pressure (>30 mm Hg), the error of the Tonopen increased, whereas the error of our device did not. The 30-gauge needle produces an insignificant improvement in accuracy over the 33-gauge needle.ConclusionsA needle-based sensor device enables accurate IOP measurements over a broad range of induced IOP.Translational RelevanceDirect measurement of IOP in the anterior chamber circumvents the influence of corneal parameters on IOP measurement.

Corneal alteration and pathogenesis in diabetes mellitus.

The incidence of diabetes mellitus (DM) and its complications have increased considerably worldwide. Diabetic keratopathy is the major complication of the cornea characterized by delayed corneal wound healing, decreasing corneal epithelial sensitivity, and recurrent corneal ulcers. There is accumulating evidence that diabetic keratopathy is correlated with the hyperglycemic state. Different corneal components may produce different alterations under hyperglycemia. In addition, diabetic nerve alteration may become a novel biomarker of early-stage DM. Abnormalities of the corneal nerve plexus have been associated with diabetic inflammatory states. There is rapidly growing evidence based on investigations of diabetic corneal nerves through in vivo confocal microscopy. Understanding the molecular pathogenesis caused by hyperglycemia may assist in the identification of novel biomarkers, as well as therapeutic targets for early treatment. This review mainly summarizes recent findings on corneal alteration and pathogenesis in DM.

Chronic dry eye induced corneal hypersensitivity, neuroinflammatory responses, and synaptic plasticity in the mouse trigeminal brainstem

BackgroundDry eye disease (DED) is a multifactorial disease associated with ocular surface inflammation, pain, and nerve abnormalities. We studied the peripheral and central neuroinflammatory responses that occur during persistent DED using molecular, cellular, behavioral, and electrophysiological approaches.MethodsA mouse model of DED was obtained by unilateral excision of the extraorbital lachrymal gland (ELG) and Harderian gland (HG) of adult female C57BL/6 mice. In vivo tests were conducted at 7, 14, and 21 days (d) after surgery. Tear production was measured by a phenol red test and corneal alterations and inflammation were assessed by fluorescein staining and in vivo confocal microscopy. Corneal nerve morphology was evaluated by nerve staining. Mechanical corneal sensitivity was monitored using von Frey filaments. Multi-unit extracellular recording of ciliary nerve fiber activity was used to monitor spontaneous corneal nerve activity. RT-qPCR and immunostaining were used to determine RNA and protein levels at d21.ResultsWe observed a marked reduction of tear production and the development of corneal inflammation at d7, d14, and d21 post-surgery in DED animals. Chronic DE induced a reduction of intraepithelial corneal nerve terminals. Behavioral and electrophysiological studies showed that the DED animals developed time-dependent mechanical corneal hypersensitivity accompanied by increased spontaneous ciliary nerve fiber electrical activity. Consistent with these findings, DED mice exhibited central presynaptic plasticity, demonstrated by a higher Piccolo immunoreactivity in the ipsilateral trigeminal brainstem sensory complex (TBSC). At d21 post-surgery, mRNA levels of pro-inflammatory (IL-6 and IL-1β), astrocyte (GFAP), and oxidative (iNOS2 and NOX4) markers increased significantly in the ipsilateral trigeminal ganglion (TG). This correlated with an increase in Iba1, GFAP, and ATF3 immunostaining in the ipsilateral TG of DED animals. Furthermore, pro-inflammatory cytokines (IL-6, TNFα, IL-1β, and CCL2), iNOS2, neuronal (ATF3 and FOS), and microglial (CD68 and Itgam) markers were also upregulated in the TBSC of DED animals at d21, along with increased immunoreactivity against GFAP and Iba1.ConclusionsOverall, these data highlight peripheral sensitization and neuroinflammatory responses that participate in the development and maintenance of dry eye-related pain. This model may be useful to identify new analgesic molecules to alleviate ocular pain.

Refractive surgery in glaucoma

AbstractLaser‐assisted refractive corrections, phakic IOL implantations and refractive Lens exchange constitute a large part of the ophthalmic surgeries that take place every year. According to many surveys the incidence of glaucoma is increasing steadily over time worldwide. It is not uncommon today that glaucoma patients or patients unaware of their condition seek consultation for refractive surgery. As a result, a significant number of patients with altered corneal properties is emerging. These patients will require glaucoma follow‐up and probably additional surgery in the future. The reshaped post refractive surgery cornea poses a challenge in the diagnosis, follow‐up, and management of glaucoma patients for the physician. This presentation highlights the do's, don'ts and pitfalls when consulting or treating patients with these characteristics.

Collagen fibrils and proteoglycans of peripheral and central stroma of the keratoconus cornea - Ultrastructure and 3D transmission electron tomography

Keratoconus (KC) is a progressive corneal disorder in which vision gradually deteriorates as a result of continuous conical protrusion and the consequent altered corneal curvature. While the majority of the literature focus on assessing the center of this diseased cornea, there is growing evidence of peripheral involvement in the disease process. Thus, we investigated the organization of collagen fibrils (CFs) and proteoglycans (PGs) in the periphery and center of KC corneal stroma. Three-dimensional transmission electron tomography on four KC corneas showed the degeneration of microfibrils within the CFs and disturbance in the attachment of the PGs. Within the KC corneas, the mean CF diameter of the central-anterior stroma was significantly (p ˂ 0.001) larger than the peripheral-anterior stroma. The interfibrillar distance of CF was significantly (p ˂ 0.001) smaller in the central stroma than in the peripheral stroma. PGs area and the density in the central KC stroma were larger than those in the peripheral stroma. Results of the current study revealed that in the pre- Descemet’s membrane stroma of the periphery, the degenerated CFs and PGs constitute biomechanically weak lamellae which are prone to disorganization and this suggests that the peripheral stroma plays an important role in the pathogenicity of the KC cornea.

Histological Corneal Alterations in Keratoconus After Crosslinking-Expansion of Findings.

To investigate histopathologic, immunohistochemical, and electron microscopic findings in 8 keratoplasty specimens with a history of corneal collagen crosslinking (CXL) for keratoconus. Five new (hitherto unreported) and 3 previously published specimens were analyzed. Corneal buttons of 8 keratoconus corneas (5-114 months after CXL) were compared with 5 keratoconus specimens without CXL and 5 normal corneas for morphological alterations. Corneal buttons were evaluated by light microscopy and immunohistochemistry using antibodies against CD34, PGP 9.5, nestin, telomerase reverse transcriptase, and Ki67 as well as by transmission electron microscopy. Keratoconus corneas after CXL showed a significant keratocyte loss (except 1 specimen with an increased keratocyte number), whereas keratoconus corneas without CXL revealed a higher keratocyte density compared with healthy controls. Keratocyte loss could be clinically correlated with corneal opacification and corneal perforation. In corneas after CXL, the remaining keratocytes appeared more polymorphic and revealed a different expression of surface markers similar to keratocytes in corneal scars. The presence of proteoglycans, nerves, and endothelial cells was unaffected by CXL. CXL may cause permanent keratocyte loss or repopulation of altered keratocytes, resulting in clinical complications such as corneal opacification or perforation. Despite its good safety profile and high effectiveness in progressive keratoconus, CXL should be performed in accordance with current guidelines strictly adhering to protocol and safety standards.

Neurotrophe Keratopathie

Corneal nerves are responsible for the reception of pain, temperature, and touch and are an important component of homeostasis of the ocular surface. When the corneal innervation is reduced, degenerative changes can be manifested as neurotrophic keratopathy (NK). In astage-dependent course, corneal epithelial alterations and ulcers may occur, even leading to perforation. The cause of NK is predominantly damage to the trigeminal nerve, which can be caused by infections (especially herpesviruses), metabolic diseases (such as diabetes mellitus) and by surgical procedures. The diagnosis of NK requires adetailed medical and ocular history, assessment of corneal sensitivity, and a complete ocular examination. The treatment of NK is oriented to the clinical severity and aims to restore the integrity of the ocular surface in order to prevent further disease progression.

A Clinical Prospective Study: Corneal alterations after cataract surgery with the technique of phacoemulsification

Abstract The purpose of this study is to investigate the effect of ultrasound energy used during phacoemulsification on corneal structure, which is the most important refractive part of the eye. This will be achieved with the comparison of preoperative and postoperative parameters related to corneal thickness and endothelium and their correlation with clinical, intrasurgical and imaging diagnostic findings. Methods: This is a clinical prospective study conducted in Evangelismos G.H.A. The patients’ enrollment was based on detailed medical history assessment, medication records as well as meticulous slit lamp examination, tonometry, best corrected visual acuity evaluation and thorough fundoscopy. Nuclear cataract sclerosis was evaluated with Lens Opacities Classification System III, and patients were scheduled for surgery. Preoperatively, with the use of specular microscopy (Tomey EM-3000; Tomey, Tennenlohe, Germany), central corneal thickness and several endothelial indices were recorded. The same measurements took place the 1st, 7th and 30th postoperative day. All the surgical operations were done without complications. Results: statistical analysis from preoperative and postoperative data showed that central corneal thickness, although elevated during the 1st and 7th postoperative day, did not present statistical significant difference in the final evaluation, with a mean elevation of only 3,9μm. Endothelial cell density levels though were reduced in all postoperative measurements (p<0,001). The final percentage endothelial cell loss was18,58%, with the most profound loss being accounted in the first postoperative week. Corneal edema and endothelial cell loss were correlated with poor visual acuity, reduced corneal curvature, increased nuclear sclerosis and prolonged time of ultrasound metrics. Conclusion: the use of confocal microscopy is a useful tool in pointing significant differences of corneal structure after uneventfull cataract phacoemulsification. The evaluation of a larger cohort of patients and a prolonged follow up procedure could give further information concerning corneal alterations after surgery. Key words: cataract, phacoemulsification, cornea, lens, endothelium, ultrasound, confocal microscopy List of Abbreviations: CCT: central corneal thickness, SD: standard deviation, CV: coefficient of variation, , ECD: endothelial cell density, ECL%: endothelial cell loss%,

An Update on Corneal Biomechanics and Architecture in Diabetes.

In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.

Noninvasive assessment of corneal alterations associated with monoclonal gammopathy.

Aggregation of monoclonal immunoglobulin can lead to organ damage. However, the necessity of invasive examination such as biopsy has hampered better understanding of the pathophysiology. Corneal crystalline deposition is a rarely reported but known ocular manifestation of multiple myeloma. It is unclear whether the cornea is a common target of monoclonal immunoglobulin deposition. We conducted a prospective clinical case-control study to objectively quantify monoclonal gammopathy-associated corneal changes as well as any therapeutic response. Using an ophthalmic Scheimpflug camera imaging for noninvasive corneal assessments, we quantified densitometry values in 30 patients. Although none had crystalline keratopathy, corneal transparency in monoclonal gammopathy patients was significantly impaired compared to that in age-matched controls, based on noninvasive Scheimpflug camera imaging. Furthermore, treatment for multiple myeloma seemed to eradicate the diffuse aggregation of monoclonal proteins. Our results indicate that exposure to monoclonal immunoglobulin may induce the accumulation of monoclonal immunoglobulin in the cornea, and ophthalmic examinations such as corneal densitometry measurements with a Scheimpflug camera may be useful for noninvasive evaluation of monoclonal immunoglobulin deposition diseases.

An in vivo confocal, prospective, masked, 36 months study on glaucoma patients medically treated with preservative-free or preserved monotherapy

The aim of this study was to evaluate the in vivo effects at 3 years of preservative-free tafluprost on corneal health. It was a prospective, masked, study on consecutive patients with a new prescription of preservative-free (PF) tafluprost (naïve-N or switched-S, 44 and 14 patients), and preserved (P) bimatoprost 0.003% or travoprost 0.004% (P-group, 35 patients). A complete ophthalmic examination and an in vivo corneal confocal microscopy evaluation were performed at baseline and every 6 months for 3 years. Ninety-three patients were enrolled, clinical parameters were similar in the groups at baseline, apart from intraocular pressure (IOP) which was lower in the S-group (p = 0.012). Both at baseline and over time, confocal microscopy parameters had different trends. At baseline, keratocyte activation was similar in the three groups (p = 0.43) but over the next months naïve patients treated with PF-tafluprost presented a significant (p = 0.004) reduction in keratocyte activation. Sub-basal nerves tended to increase in patients switched to PF-tafluprost (p = 0.07) while were stable in the other two groups (p = 0.11 in PF and 0.40 in P group). Grade of tortuosity was stable over time in the three groups. Beading-like formations were stable over time for the P- and the PF-group, while significantly increased in the S-group (p = 0.027). Endothelial density values were statistically different at baseline (p = 0.007), they decreased both in PF-group and in S-group (p = 0.048 and 0.001, respectively), while increased in P-group (p = 0.006). Our study is the first to show that a PF-tafluprost formulation does not significantly alter the corneal structures as examined by confocal microscopy after 36 months of topical daily therapy, while improving corneal alterations due to chronic preserved therapies.

Mapping the entire nerve architecture of the cat cornea.

To provide a complete nerve architecture and neuropeptide distribution in the cat cornea. Two adult domestic cats. The cat corneas were stained with protein gene product (PGP) 9.5 antibody-a pan marker for nerve fibers-and then divided into four quarters and double labeled with calcitonin gene-related peptide (CGRP) or substance P (SP) antibodies. Relative corneal nerve fiber densities and nerve terminals were evaluated in whole mount images by computer-assisted analysis. An average of 21.5±2.1 thick stromal nerves enters the cornea around the limbus where they split into many branches going up to the anterior stroma. Some branches link to each other, but most of them penetrate the basement membrane in the periphery to give origin to subbasal bundles, which run centripetally and merge to form a whirl-like structure (vortex) at the center. These nerve bundles send out many fine terminals that innervate the epithelial cells. Subbasal nerve density and nerve terminals were greater in the center than in the periphery of the cornea. Additionally, CGRP-positive central epithelial nerve fibers and terminals were more abundant than SP-positive nerves and terminals. The architecture of cat corneal nerves shows similarities to human and mouse cornea innervation. This study provides useful data for researchers who use the cat model to assess corneal nerve pathological alterations, as well as in the veterinary field where corneal opacities, ulcerations, and infections damage the nerves and decrease sensitivity.

Protective Effect of Chrysin on Corneal Structural Alterations Induced by Sofosbuvir in Male Albino Rats (Histological and Immunohistochemical Study)

Abstract Background: Sofosbuvir is a nucleotide analog that has activity against all hepatitis c virus genotypes. Aim of work: The aim of this study was to demonstrate the effect of Sofosbuvir

Corneal biomechanics and intraocular pressure changes after uneventful phacoemulsification surgery

Background Biomechanics of the cornea is represented by corneal hysteresis (CH), which is defined as the viscous damping owing to viscoelastic resistance of the cornea to deformation. Aim Assessing intraocular pressure (IOP) and corneal biomechanics alterations after phacoemulsification. Patients and methods Thirty eyes were uneventfully operated on using phacoemulsification. CH, corneal resistant factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann correlated intraocular pressure (IOPg) values were recorded by ocular response analyzer (ORA). Central corneal thickness (CCT) was evaluated using pentacam preoperatively and postoperatively after 1 day, 1 week, and 1 month. Results Patients comprised 22 males and 8 females, with a mean age of 63.8±6.8years. Preoperative mean CCT was 532.4±39.2 µm, mean CH was 9.4±1.7 mmHg, mean CRF was 9.5±2.0 mmHg, mean IOPg was 15.4±3.9 mmHg, and mean IOPcc was 17.1±3.6 mmHg. CCT significantly increased after 1 day and significantly decreased after 1 week, and decreased again after 1 month but remained significantly higher. CH decreased significantly after 1 day and increased to the preoperative values after 1 week and 1 month. CRF significantly increased after 1 day and then decreased significantly after 1 week and remained significantly lower. Both IOPcc and IOPg insignificantly elevated after 1 day, then significantly declined after 1 week, and insignificantly increased after 1 month but was still lower than the preoperative value. CH, CRF, and CCT correlated significantly except for 1 day after surgery. Conclusion Cataract surgery causes corneal structural alterations, changing biomechanical properties and IOP initially. CCT contributes in these parameters, as there is a correlation with CH and CRF.