The Impact of Dry Eye Disease on Corneal Biomechanics Analyzed with Corneal Visualization Scheimpflug Technology

<b>Background/Objectives</b>: Dry eye disease (DED) is an ocular surface disease with unstable tear film hemeostasis that could influence the corneal biomechanics. The study aimed to elucidate the impact of dry eye severity on corneal biomechanics. <b>Methods</b>: This is a prospective cohort study that enrolled 72 participants with or without dry eye severity. All subjects received dry eye and corneal biomechanic assessment. Dry eye patients were divided into non-DED (>6 s) and DED (<6 s) groups based on the average non-invasive keratograph tear break-up time to compare their performance in corneal biomechanics. We further analyzed the correlation between the corneal biomechanic parameters and dry eye indexes for these patients. <b>Results</b>: In this study, 38 non-DED patients and 34 DED patients were enrolled for analysis. The two groups showed significant differences in first applanation (A1) deflection area (<i>p</i> = 0.002), A1 delta arc length (<i>p</i> = 0.024), second applanation (A2) deformation amplitude (<i>p</i> = 0.024), and whole eye movement [mm] (<i>p</i> = 0.021). Moreover, both A1 deflection area and A1 delta arc length revealed significantly correlated with tear meniscus height in DED patients. <b>Conclusions</b>: DED and its severity can affect corneal biomechanics. Tear volume on the ocular surface could be one of the important factors to influence corneal biomechanics.