Comparison of Biomechanical Indices Measured by Ocular Response Analyzer Between Children and Elderly: a Systematic Review

Biomechanical study of the visual system by ocular response analyzer investigates the inter-structural biological relationships, mechanics, and function of the visual system. This review aimed to investigate the changes in corneal biomechanical parameters with age and sex. The articles published in PubMed between 2000 and 2021 were investigated and critiqued, and valid scientific evidence was collected, reviewed and concluded according to the inclusion and exclusion criteria. Most studies showed that corneal biomechanical changes occur infrequently in children up to the age of 20y, and with increasing age and wider age range, there was a significant decrease in corneal biomechanical indices, especially corneal hysteresis. In children and adults, most studies have shown that these biomechanical indicators, especially corneal resistance factor, were higher in females. Although hormonal changes may contribute to this finding, the role of axial length and other biometric indicators should not be ignored. The axial length, the intraocular pressure, and the corneal thickness are other factors associated with biomechanical parameters that should be taken into account in clinical diagnosis and management especially for patients undergoing refractive surgery as well as keratoconus patients.