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

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Abstract

Aims

To determine the changes in corneal biomechanical parameters in patients with diabetes mellitus (DM) in comparison with controls.

Methods

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).

Results

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 1.34 mmHg (95% confidence interval [CI] 0.60–2.08 mmHg, P < 0.001) for IOPg and 0.85 mmHg (95% CI 0.18–1.51 mmHg, P = 0.013) for IOPcc, 0.38 mmHg (95% CI 0.01–0.75, P = 0.047) for CH and 0.63 mmHg (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).

Conclusions

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.

Registration

PROSPERO registration No CRD4201705465.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

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Authors and Affiliations

  1. Department of Ophthalmology Center, Huizhou Municipal Central Hospital, Huizhou, Guangdong Province, People’s Republic of China

    Xiaoyi Wang, Guihua Xu, Juanjuan Wang, Lili Chen & Zilin Chen

  2. Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    Wei Wang & Mingguang He

Authors
  1. Xiaoyi Wang
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  2. Guihua Xu
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  3. Wei Wang
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  4. Juanjuan Wang
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  5. Lili Chen
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  6. Mingguang He
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  7. Zilin Chen
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Contributions

GX, WW, MH and ZC conceived the idea and designed the study. XW, JW and LC collected the data. GX and WW performed the data analysis. All authors participated in the critical revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zilin Chen.

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The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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As this was a review study, no ethics approval was required.

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For this type of study, informed consent was not required.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

Xiaoyi Wang, Guihua Xu and Wei Wang are Co-first authors.

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Wang, X., Xu, G., Wang, W. et al. Changes in corneal biomechanics in patients with diabetes mellitus: a systematic review and meta-analysis. Acta Diabetol 57, 973–981 (2020). https://doi.org/10.1007/s00592-020-01481-0

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  • DOI: https://doi.org/10.1007/s00592-020-01481-0

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