Evidence of Ectasia-Like Corneal Changes After Pregnancy

Purpose: Recent research has uncovered structural changes in the corneas of women over the course of pregnancies and beyond. Yet, longitudinal data on high-resolution corneal metrics are lacking in the current literature, and understanding of a possible reversibility of these changes remains limited. This prospective study aims to quantify corneal metrics in healthy pregnant women prenatally and postnatally, describing the natural evolution of the corneal structure during and after pregnancy. Methods: Anterior segment optical coherence tomography and Pentacam Scheimpflug measurements were performed repeatedly on healthy pregnant women, assessing corneal refractive power, corneal topography, and tomography at various intervals during pregnancy and after childbirth. Corneal refractive indices, curvature, and spatial thickness values were compared throughout pregnancy and in the postpartum period using linear mixed models. Results: Fifty-two eyes of 26 pregnant women were included in the study. While corneal refractive and region-specific corneal thickness values showed no significant changes during the prepartum phase, the postpartum-to-prepartum comparison revealed a significant thickness reduction in the inferotemporal cornea, accompanied by an increase in corneal refractive power and decrease in spherical equivalent. Intraocular pressure increased significantly after childbirth. Conclusions: The corneal structure remains stable throughout healthy pregnancies; however, postpartum changes hint toward late adaptations after childbirth, which should be taken into consideration in corneal and refractive surgery.