Abstract
Purpose
This study aimed to assess the impact of wearing swimming goggles (SG) on corneal biomechanics.
Methods
Corneal deformation response, central corneal thickness (CCT), intraocular pressure (IOP) and biomechanically corrected intraocular pressure (bIOP) were measured with the Corvis system (Oculus Optikgeräte GmbH, Wetzlar, Germany) in thirty-one healthy young adults while wearing a drilled SG. All measurements were obtained before, at 30 s, 2 min, 3.5 min and 5 min of wearing SG, just after SG removal and after 2 min of SG removal.
Results
The corneal biomechanics is sensitive to SG wear, observing lower corneal deformability during SG use. Specifically, wearing SG caused an increase in the time and length of the first applanation and radius curvature at the highest concavity, as well as a decrease and in the velocity of the first applanation and time and deformation amplitude of the second applanation (p < 0.001 in all cases). After SG removal, corneal biomechanical parameters showed a rebound-effect, obtaining a higher corneal deformability in comparison with baseline reading (p-corrected < 0.05 in all cases). Additionally, IOP and bIOP significantly increased while wearing SG (p < 0.001 in both cases), whereas CCT remained stable (p = 0.850).
Conclusions
Wearing SG modifies the biomechanical properties of the cornea, with reduced corneal deformability during SG wear. The outcomes of this study should be taken into consideration when making clinical decisions in subjects at high risk of developing corneal ectasias or glaucoma, as well as in the post-surgical management of these ocular conditions.
Similar content being viewed by others
Avoid common mistakes on your manuscript.
Introduction
Biomechanics is often defined as mechanics applied to biology [1], and due to the viscoelastic characteristics of the cornea, it is possible to determine its biomechanical behaviour after applying a given force [2]. The clinical application of the corneal biomechanics has gained attention in the last years [3,4,5]. The assessment of corneal biomechanics has special relevance for the diagnosis, prognosis and treatment planning of different ocular conditions such as corneal ectatic disorders or glaucoma [4, 5], as well as for improving the safety and effectiveness of different ocular treatments or refractive surgical techniques [6,7,8,9,10,11].
There is a relationship between alterations in corneal biomechanics and different factors and ocular parameters such as age [12, 13], diabetes [14], caffeine intake [15], hormonal changes [16], level of hydration and fasting [17], exposure to ultraviolet radiation [18], intraocular pressure (IOP) [13, 19], refractive error [20], axial length [13], corneal central thickness and corneal curvature [13], ocular surgery [9, 10, 21] or orthokeratology [22, 23] among others.
In addition, activities that are known to increase IOP, such as eye rubbing and psychological stress, have also been associated with changes in the biomechanical properties of the cornea [24, 25]. In this regard, the use of swimming goggles (SG) has been shown to acutely increase IOP; this effect is attributed to the tension transmitted by the goggle headband and eye cups which compresses the orbital tissues and vasculature and consequently, modifying the eye dimensions [26, 27]. In a previous study, we assessed the impact of wearing SG on the anterior segment morphology, using the Pentacam system, and an acute corneal thinning, iridocorneal angle reduction and intraocular pressure elevation were observed [28]. However, to date, the impact of wearing SG on corneal biomechanical properties remains unknown.
In view of these limitations, the present study aimed to determine the short-term effect of wearing SG on the corneal biomechanics, as measured with corneal visualisation Scheimpflug technology, which has a good repeatability and reproducibility to analyse the corneal biomechanics in vivo and potential applicability in clinical settings [29,30,31]. Based on the previously mentioned evidence showing acute changes in IOP and eye anterior morphology with the use of SG [26, 28], and the well-proven association between IOP and corneal biomechanics [32], we hypothesised that SG wearing would alter the biomechanical properties of the cornea. Assessment of corneal biomechanics responses to habits or dailies activities such as SG wear may provide guidelines for the eye care community in order to minimise the risk for the development and progression of corneal ectasias or glaucoma, especially in high-risk individuals. A better understanding of the corneal biomechanical properties would also help to design strategies for the management of these ocular diseases at pre- and post-operative stages.
Material and methods
Participants and ethical approval
For sample size calculation, we performed an a priori power analysis, using the GPower 3.1 software [33], based on an expected low effect size (Cohen’s d = 0.20), and considering a power of 0.80 and alpha of 0.05. This calculation determined that 26 participants were required to achieve this desired level of accuracy. At this point, we recruited 31 healthy young adults (19 women; mean age ± standard deviation, 21.5 ± 1.9 years) to increase the statistical power and to account for possible drop out. Participants had a mean spherical equivalent of − 1.62 ± 1.28 D, ranging from 0 D to − 5.75 D. The study was carried out at the CLARO (Clinical and Laboratory Applications of Research in Optometry) laboratory located at the Faculty of Sciences of the University of Granada (Spain) from September 2019 to December 2019. The following inclusion criteria were considered: (1) no systemic or ocular disease, and not taking any medication; (2) no history of previous ocular surgery, trauma or orthokeratology; (3) baseline intraocular pressure value ≤ 21 mmHg [34]; and (4) to refrain for wearing contact lenses and consumption of alcohol/caffeine-based drinks for at least 8 h before attending to the experimental session. Informed consent was obtained from all participants, and the experimental protocol was approved by the University of Granada Institutional Review Board (IRB approval: 438/ CEIH/2017).
Experimental design
All participants wore the same model of SG (Nabaiji, Decathlon Group Inc., Villeneuve d’Ascq, France). The SG consisted of two separated rigid plastic eye cups with a rubber cushioning seal surrounding the lip of each cup and a non-adjustable elastic strap. Vertical and horizontal goggles widths of the cup were 45 mm and 33 mm, respectively, from the internal rubber seals of each eyepiece. Based on the published studies of Paula et al. [35] and Jiménez et al. [28], we used a SG with part of the plastic right eye piece drilled, which allowed us to measure IOP and corneal biomechanics parameters while wearing the SG. Previous studies have evidenced that the impact of SG wear on the ocular physiology reversed immediately after the removal of the SG [28, 35], and thus, we considered appropriate to use a modified SG, since it was the only alternative to assess the eye changes during SG wear. The structure of the cup of the right eye piece was preserved to achieve a similar level of pressure to real-life conditions (see Fig. 1 for a photograph of the SG).
A repeated measures design was followed to evaluate the short-term effects of SG wearing on the biomechanical properties of the cornea. Also, the impact of SG wearing on IOP and CCT was assessed. The point of measurement (baseline, 30 s, 2 min, 3.5 min, 5 min, immediately after SG removal [recovery 1, R1] and 2 min after removal [recovery 2, R2]) was considered as the only within-participants factor. Each participant followed an identical protocol, and all measurements were taken by the same optometrist.
Instruments and measurements
The biomechanical properties of the cornea were assessed by Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) at seven points of measurement, before (baseline), during (30 s, 2 min, 3.5 min and 5 min) and after SG wearing (R1 and R2). This instrument used a non-contact tonometer based on air puff indentation. At the same time, a high-speed Scheimpflug camera took over 4000 frames per second, which allowed direct real-time visualisation of the corneal deformation response during an entire cycle after each air pulse. As a consequence, from the disturbed state by each air puff, the cornea firstly flattens (inward applanation), reaching the highest concavity, and again undergoes another applanation state (outward applanation) before becoming fully restored to its normal state. The CorVis ST provides a number of parameters, and for this study, we considered the time of the first and second applanations (A1T and A2T, respectively), the length of the first and second applanations (A1L and A2L, respectively), the amplitude of the first and second applanations (A1D and A2D, respectively), the velocity of the first and second applanations (A1V and A2V, respectively), the deformation amplitude at the highest concavity (HCDA), the time to highest concavity (HCT), the highest concavity curvature (HCR) and the peak distance (PD) (see Jiménez et al. [15] for a description of these measurements).
Additionally, measurements of the corneal central thickness (CCT), standard intraocular pressure (IOP, based on the inward applanation) and biomechanically corrected IOP value (bIOP) were obtained in each point of measurement. The bIOP is referred to as the IOP reading free from the effects of corneal parameters [36].
Procedure
Upon arrival at the laboratory, participants read and signed the consent form, and completed a questionnaire with demographic information. Then, the baseline measurement with the CorVis ST was performed. Just after this, the participant wore the SG and the CorVis ST measurements were taken at 30 s, 2 min, 3.5 min and 5 min of SG wearing. Immediately after the last measurement, the SG was removed and a new Corvis ST measurement was taken (R1). Finally, after two minutes of SG removal, a new measurement was taken (R2). All measurements were taken from a randomly selected eye for each subject, and Corvis ST examinations with the quality score “OK” were always obtained.
Statistical analysis
Normal distribution and homogeneity of variances were checked by the Shapiro–Wilk and Levene’s tests, respectively (p > 0.05). Then, separate repeated measures one-way analyses of variance (ANOVAs) with Holm–Bonferroni adjusted post hoc comparisons were carried out to assess the effect of SG use on corneal biomechanics (A1T, A1V, A1D, A1L, A2T, A2V, A2D, A2L, HCDA, HCT, HCR, PD), IOP, bIOP and CCT. For each dependent variable, the point of measurement (baseline, 30 s, 2 min, 3.5 min and 5 min; R1 and R2) was considered as the only within-participants factor. The partial eta-squared (η2) and Cohen’s d were reported to describe the magnitude of the differences for F and T-tests, respectively. The level of statistical significance was set at 0.05. The JASP statistics package (version 0.13.1.0) was used for statistical analyses.
Results
Descriptive values (mean ± standard deviation) for all the measurements taken are depicted in Table 1.
Intraocular pressure
We found statistically significant differences for IOP and bIOP while wearing the SG (F6,180 = 11.14, p < 0.001, η2 = 0.27 and F6,180 = 11.35, p < 0.001, η2 = 0.28, respectively). For IOP, post hoc analyses demonstrated greater IOP values at 5 min in comparison with the baseline measurement (p corrected = 0.025, d = 0.60). Higher IOP readings were also obtained at baseline, 30 s, 2 min, 3.5 min and 5 min in comparison with the measurement obtained immediately after SG removal (p-corrected = 0.01, d = 0.68; p-corrected = 0.008, d = 0.71; p-corrected = 0.005, d = 0.75; p-corrected = 0.01, d = 0.68; and p-corrected < 0.001, d = 0.88, respectively), as well as after 2 min of recovery (p-corrected = 0.007, d = 0.72; p-corrected = 0.008, d = 0.70; p-corrected = 0.006, d = 0.73; p-corrected = 0.013, d = 0.65; and p-corrected < 0.001, d = 0.88, respectively). Similarly, post hoc analyses for bIOP evidenced a heightened IOP response after 5 min of SG wear in comparison with the baseline measurement (p-corrected = 0.027, d = 0.60). In addition, there were higher IOP values at baseline, 30 s, 2 min, 3.5 min and 5 min when compared to the R1 (p-corrected = 0.009, d = 0.68; p-corrected = 0.007, d = 0.70; p-corrected = 0.004, d = 0.75; p-corrected = 0.01, d = 0.67; and p-corrected < 0.001, d = 0.86, respectively) and R2 (p-corrected = 0.002, d = 0.80; p-corrected = 0.006, d = 0.72; p-corrected = 0.004, d = 0.75; p-corrected = 0.011, d = 0.66; and p-corrected < 0.001, d = 0.90) measurements (Fig. 2).
Central corneal thickness
The use of SG was far from having a statistically significant effect on CCT (F6,180 = 0.442, p = 0.850).
Corneal biomechanics parameters
In regard to the first applanation, there was a main effect of the point of measurement for A1T, A1V, A1L and A1D (F6,180 = 11.39, p < 0.001, η2 = 0.28; F6,180 = 26.42, p < 0.001, η2 = 0.47; F6,180 = 6.846, p < 0.001, η2 = 0.19; and F6,180 = 2.728, p = 0.015, η2 = 0.08, respectively).
Post hoc comparisons only showed a significant increase in A1T at 5 min of SG use in comparison with the baseline measurement (p-corrected = 0.020, d = 0.62). The A1T value obtained immediately after SG removal (R1) was lower than the measurements taken at baseline, 30 s, 2 min, 3.5 min and 5 min (p-corrected = 0.023, d = 0.61; p-corrected = 0.007, d = 0.71; p-corrected = 0.004, d = 0.75; p-corrected = 0.011, d = 0.68; and p-corrected < 0.001, d = 0.87, respectively). In a similar manner, A1T was lower after 2 min of SG removal in comparison with the baseline (p-corrected = 0.023, d = 0.61), 30 s (p-corrected = 0.007, d = 0.71), 2 min (p-corrected = 0.004, d = 0.75), 3.5 min (p-corrected = 0.011, d = 0.68) and 5 min (corrected p value < 0.001, d = 0.87) measurements (Fig. 3, panel A).
For A1V, post hoc analyses revealed a decrease while SG wear in comparison with the baseline value (p-corrected = 0.001, d = 0.81 at 30 s; p-corrected = 0.007, d = 0.67 at 2 min; p-corrected = 0.005, d = 0.70 at 3.5 min; and p-corrected < 0.001, d = 0.90 at 5 min). The R1 and R2 measurements were also higher than those taken at baseline (p-corrected = 0.006, d = 0.68; and p-corrected = 0.005, d = 0.71, respectively), 30 s (p-corrected < 0.001, d = 1.21; and p-corrected < 0.001, d = 1.15, respectively), 2 min (p-corrected < 0.001, d = 1.13; and p-corrected < 0.001, d = 1.02, respectively), 3.5 min (p-corrected < 0.001, d = 1.12; and p-corrected < 0.001, d = 1.14, respectively) and 5 min (p-corrected < 0.001, d = 1.40; and p-corrected < 0.001, d = 1.29, respectively) of SG wear (Fig. 3, panel B). For its part, post hoc tests for A1L displayed an increase at 2 min, 3.5 min and 5 min of SG wear in comparison with the baseline measurement (p-corrected = 0.025, d = 0.64; p-corrected < 0.017, d = 0.676; and p-corrected = 0.029, d = 0.62, respectively). After 2 min of SG removal, A1L values were lower than the measurement taken at 3.5 min and 5 min of SG wear (p-corrected = 0.046, d = 0.59; and p-corrected = 0.011, d = 0.70, respectively) (Fig. 3, panel C). Lastly, post hoc for A1D showed no significant changes in any post hoc comparison (p-corrected > 0.05 in all cases).
Regarding parameters related to the second applanation, there was also a main effect of the point of measurement for A2T, A2V, A2L and A2D with the SG (F6,180 = 11.60, p < 0.001, η2 = 0.28; F6,180 = 2.16, p = 0.049, η2 = 0.07; F6,180 = 5.60, p < 0.001, η2 = 0.16; F6,180 = 6.47, p < 0.001, η2 = 0.18, respectively). Post hoc comparisons showed a decrease in A2T during SG wearing at 30 s, 2 min, 3.5 min and 5 min in comparison with the baseline reading (p-corrected = 0.014, d = 0.66; p-corrected = 0.002, d = 0.81; p-corrected = 0.014, d = 0.67; and p-corrected = 0.001, d = 0.85, respectively). The recovery values (R1 and R2) were significantly higher than the measurements taken at 30 s (p-corrected < 0.001, d = 0.93; and p-corrected < 0.001, d = 0.85, respectively), 2 min (p-corrected = 0.014, d = 0.65; and p-corrected = 0.030, d = 0.58, respectively), 3.5 min (p-corrected = 0.014, d = 0.66; and p-corrected = 0.021, d = 0.61, respectively) and 5 min (p-corrected = 0.008, d = 0.70; and p-corrected = 0.014, d = 0.64, respectively) of SG wear (Fig. 4, panel A). Post hoc analyses for A2V showed no changes between any comparison (p-corrected > 0.05 in all cases). For A2L, there were greater values at 30 s and 5 min of SG wear in comparison with the measurement taken immediately after SG removal (p-corrected = 0.028, d = 0.64; and p-corrected = 0.048, d = 0.60, respectively) (Fig. 4, panel B). The analysis of A2D revealed lower values at 30 s and 2 min of SG wear in comparison with the baseline measurement (p-corrected = 0.015, d = 0.67; and p-corrected = 0.011, d = 0.70, respectively) (Fig. 4, panel C).
HCDA showed statistical significance for the point of measurement (F6,180 = 11.00, p < 0.001, η2 = 0.27). Post hoc comparisons evidenced a higher HCDA when the SG was removed (R1) in comparison with the baseline value and measurements taken while wearing the SG (baseline, 30 s, 2 min, 3.5 min and 5 min; p-corrected = 0.024, d = 0.61; p-corrected < 0.001, d = 0.86; p-corrected = 0.005, d = 0.74; p-corrected = 0.008, d = 0.70; and p-corrected = 0.001, d = 0.83, respectively), as well as after 2 min of SG removal (baseline, 30 s, 2 min, 3.5 min and 5 min; p-corrected < 0.023, d = 0.62; p-corrected < 0.001, d = 0.90; p-corrected = 0.008, d = 0.70; p-corrected = 0.014, d = 0.65; and p-corrected = 0.002, d = 0.80, respectively) (Fig. 5, panel A).
There was also a main effect of the point of measurement for HCR (F6,180 = 6.778, p < 0.001, η2 = 0.18), with post hoc analyses showing statistically significant differences for the comparison baseline versus 30 s of SG wear (p-corrected = 0.017, d = 0.67), 30 s of SG wear versus R1 (p-corrected = 0.019, d = 0.65), 30 s of SG wear versus R2 (p-corrected < 0.001, d = 0.86) and 2 min of SG wear versus R2 (p-corrected < 0.022, d = 0.64) (Fig. 5 panel B).
For its part, PD revealed statistically significant differences for the point of measurement (F6,180 = 9.40, p < 0.001, η2 = 0.24). Post hoc comparisons evidenced a higher PD immediately after SG removal in relation to all the previously taken measurements (baseline, 30 s, 2 min, 3.5 min and 5 min; p-corrected = 0.016, d = 0.65; p-corrected = 0.011, d = 0.69; p-corrected = 0.008, d = 0.71; p-corrected = 0.016, d = 0.66; and p-corrected = 0.005, d = 0.75, respectively), as well as after 2 min of SG removal comparison with the baseline (p-corrected < 0.002, d = 0.82), 30 s (p-corrected = 0.019, d = 0.62), 2 min (p-corrected = 0.018, d = 0.64), 3.5 min (p-corrected = 0.018, d = 0.64) and 5 min (p-corrected = 0.002, d = 0.80) measurements (Fig. 5, panel C). Lastly, HCT was far from showing statistically significant differences for the point of measurement (F6,180 = 0.558, p = 0.764).
Discussion
Our study assessed the short-term effects of SG wear on the biomechanical properties of the cornea in a healthy young population. Complementarily, the IOP behaviour and CCT were also examined. There have been a number of studies have reported changes in the eye physiology with the use of SG [26, 28], however, to the best of our knowledge, this is the first study to evaluate the corneal biomechanical behaviour during and after SG wear. We found significant alterations in corneal biomechanics and IOP, suggesting that the use of SG causes a reduction in corneal deformability. Also, greater values of both non-corrected and biomechanically corrected IOP were observed while wearing the SG, but no changes were found for CCT.
There is scientific evidence that IOP suffers alterations with the use of SG, namely IOP increases during and after SG wear regardless of the physical structure of SG and duration of their use [26, 28, 37, 38]. Our findings agree with these results, since we found an average IOP rise of approximately 2 mmHg during SG wear and rapidly returning to baseline values after SG removal. Due to the fact that IOP measurements may be influenced by the biomechanical properties of the cornea, bIOP values based on the first applanation were also considered [36]. Similarly, a significant bIOP increase was observed while SG wear. Therefore, as indicated by Morgan et al. [26], it is plausible that the mechanical pressure exerted by the SG on the orbital tissue compress the ocular globe and consequently could lead to a significant increase in IOP.
Wearing SG has also demonstrated to induce acute changes in the ocular biometrics. In this regard, previous studies have reported an increase in axial length and a reduction in CCT and iridocorneal angle [27]. In a recent study from this research group, using the Pentacam system, we found an increase in IOP and a reduction in CCT while wearing a drilled SG [28]. However, this finding did not fully agree with our results, since we found an elevation in both IOP and bIOP measurements without changes in CCT, corroborating that bIOP from the Corvis ST is independent of CCT [39]. Somewhat surprisingly, although we used the same SG of our previous study, we did not observe a reduction in CCT, which could be explained by the different instruments used in both studies. The Pentacam is based on a 360-degree rotating Scheimpflug camera which acquires images that contain measurement points on the front and back corneal surfaces to determine a true elevation map, and the Corvis ST, also based on ultra-high-speed Scheimpflug technology, acquires the measurements during the deformation process but only in the horizontal meridian. Although a high repeatability and agreement in CCT measurements have been reported for healthy eyes [40,41,42], it is plausible to expect that the ocular deformation induced by the SG may differ in different corneal meridians. The mechanical pressure exerted by the SG on the ocular globe may be stronger in the vertical than the horizontal direction, but this hypothesis needs to be tested in future studies.
Regarding corneal biomechanics, our results showed smaller values of A1V, A2T, A2D and higher of A1T, HCR during SG wear, which could indicate that SG wearing causes a higher corneal stiffness. Accordingly, a less deformable cornea reaches the first applanation faster, shows a smaller concavity and reaches the second applanation slower [43]. Based on these results, SG wear seems to enhance corneal stiffness, but these changes rapidly recover after SG removal. Nevertheless, as reported above, the mechanical pressure exerted by the goggles on the orbital tissue and adjacent scleral tissue may be different depending corneal direction considered, leading to unequal changes in viscoelasticity in the corneal stroma in different meridians [44,45,46,47]. However, due to technical characteristics of the Corvis ST, this possibility cannot be discerned with the current results, which required the assessment of the corneal biomechanics along different meridians.
Remarkably, A1T, A1V, A1L, A2D, HCDA, HCR and PD exhibited a rebound effect when the SG was removed, with this change lasting for at least 2 min. We consider that it would be of interest to test how much time is needed to stabilise the corneal biomechanics after SG wear. (e.g. eye rubbing, lid massages, sleep face down or SG wearing), which would allow preventing adverse consequences for ocular health. Additionally, it is important that eye care specialists are mindful of these results to minimise confounding factors in clinical decision-making. The current findings may be of special relevance in the short- and long-term management of clinical populations with alterations in the corneal biomechanics (e.g. corneal ectatic disorders or glaucoma). Future studies should examine the risks associated with the use of different SG designs in these individuals, aiming to provide recommendations about the most pertinent type of SG, if any, for the minimisation of ocular side effects.
Several limitations should be acknowledged in this study in order to make a correct interpretation of the current outcomes. First, the generalisability of our findings is potentially limited since a greater pressure on ocular tissues may occur with an intact SG (without drilling the plastic eye cup) and with the influence of external water pressure upon goggles. Also, all measurements were taken in a resting state, and therefore, the effects of wearing SG on IOP and corneal biomechanics could differ with physical activity. Second, we used a specific type of SG and other goggle designs could cause different effects on the biomechanical properties of the cornea to those observed in this investigation. Third, there are claims that corneal stiffness is age-dependent [48, 49], and further studies with a larger sample size are needed to determine the effect of SG wear on corneal biomechanics in different age groups. Fourth, some ocular measurements (e.g. scleral rigidity, anterior chamber angle, anterior chamber depth, etc.) have demonstrated to differ between hyperopic and myopic eyes [50,51,52]. In the current study, the experimental sample was formed by emmetropes and myopes, and it did not allow us to compare the corneal biomechanics changes caused by wearing swimming goggles between myopic and hyperopic eyes. Lastly, healthy subjects were included in this study, and thus, our results should be cautiously interpreted in clinical populations (e.g. individuals with corneal ectasias or glaucoma patients), who have demonstrated to have an altered corneal deformation response [53, 54].
In conclusion, our data revealed changes in most corneal biomechanical parameters while wearing SG, showing a heightened corneal stiffness with the use of SG. These effects may be due to modifications in the viscoelastic properties of the cornea to a given force. The assessment of corneal deformation responses in other ocular meridians would help to better characterise the corneal biomechanics changes induced by SG. The current results may be of interest for the management of ocular conditions that are known to be tightly linked to the biomechanical properties of the cornea (e.g. corneal ectasias and glaucoma).
References
Fung Y (2013) Biomechanics: mechanical properties of living tissues, 2nd edn. Springer, New York
Piñero DP, Alcón N (2015) Corneal biomechanics: a review. Clin Exp Optom 98:107–116. https://doi.org/10.1111/cxo.12230
Kling S, Hafezi F (2017) Corneal biomechanics—a review. Ophthalmic Physiol Opt 37:240–252. https://doi.org/10.1111/opo.12345
Salomão MQ, Hofling-Lima AL, Esporcatte LPG et al (2020) The role of corneal biomechanics for the evaluation of ectasia patients. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph17062113
Prata TS, Lima VC, Guedes LM et al (2012) Association between corneal biomechanical properties and optic nerve head morphology in newly diagnosed glaucoma patients. Clin Exp Ophthalmol 40:682–688. https://doi.org/10.1111/j.1442-9071.2012.02790.x
Vinciguerra R, Romano V, Arbabi EM et al (2017) In vivo early corneal biomechanical changes after corneal cross-linking in patients with progressive keratoconus. J Refract Surg 33:840–846. https://doi.org/10.3928/1081597X-20170922-02
Bamdad S, Sedaghat MR, Yasemi M, Maalhagh M (2020) Intracorneal stromal ring can affect the biomechanics of ectatic cornea. J Ophthalmol 2020:1–6. https://doi.org/10.1155/2020/4274037
Hashemi H, Asgari S, Mortazavi M, Ghaffari R (2017) Evaluation of corneal biomechanics after excimer laser corneal refractive surgery in high myopic patients using dynamic scheimpflug technology. Eye Contact Lens 43:371–377. https://doi.org/10.1097/ICL.0000000000000280
Kato Y, Nakakura S, Asaoka R et al (2017) Cataract surgery causes biomechanical alterations to the eye detectable by Corvis ST tonometry. PLoS ONE. https://doi.org/10.1371/journal.pone.0171941
Modis L, Hassan Z, Szalai E et al (2016) Ocular biomechanical measurements on post-keratoplasty corneas using a Scheimpflug-based noncontact device. Int J Ophthalmol 9:235–238. https://doi.org/10.18240/ijo.2016.02.09
Dackowski EK, Lopath PD, Chuck RS (2020) Preoperative, intraoperative, and postoperative assessment of corneal biomechanics in refractive surgery. Curr Opin Ophthalmol 31:234–240
Rogowska ME, Iskander DR (2015) Age-related changes in corneal deformation dynamics utilizing scheimpflug imaging. PLoS ONE. https://doi.org/10.1371/journal.pone.0140093
Miki A, Maeda N, Ikuno Y et al (2017) Factors associated with corneal deformation responses measured with a dynamic scheimpflug analyzer. Investig Ophthalmol Vis Sci 58:538–544. https://doi.org/10.1167/iovs.16-21045
Pérez-Rico C, Gutiérrez-Ortíz C, González-Mesa A et al (2015) Effect of diabetes mellitus on Corvis ST measurement process. Acta Ophthalmol 93:e193–e198. https://doi.org/10.1111/aos.12530
Jiménez R, Molina R, Redondo B, Vera J (2020) Effects of caffeine intake on the biomechanical properties of the cornea: a placebo-controlled, double-blind, crossover pilot study in low caffeine consumers. Graefe’s Arch Clin Exp Ophthalmol 258:2449–2458. https://doi.org/10.1007/s00417-020-04835-0
Yang Y, Ye J, Ng TK et al (2020) Changes in corneal biomechanics during pregnancy in Chinese healthy female. Eur J Ophthalmol. https://doi.org/10.1177/1120672120902034
Oltulu R, Satirtav G, Ersan I et al (2016) The effect of dehydration and fasting on corneal biomechanical properties and intraocular pressure. Eye Contact Lens 42:392–394. https://doi.org/10.1097/ICL.0000000000000220
Schweitzer C, Korobelnik JF, Boniol M et al (2016) Associations of biomechanical properties of the cornea with environmental and metabolic factors in an elderly population: the ALIENOR study. Investig Ophthalmol Vis Sci 57:2003–2011. https://doi.org/10.1167/iovs.16-19226
Kling S, Marcos S (2013) Contributing factors to corneal deformation in air puff measurements. Investig Ophthalmol Vis Sci 54:5078–5085. https://doi.org/10.1167/iovs.13-12509
Lee R, Chang RT, Wong IYH et al (2016) Assessment of corneal biomechanical parameters in myopes and emmetropes using the Corvis ST. Clin Exp Optom 99:157–162. https://doi.org/10.1111/cxo.12341
Sefat SMM, Wiltfang R, Bechmann M et al (2016) Evaluation of changes in human corneas after femtosecond laser-assisted LASIK and small-incision lenticule extraction (SMILE) using non-contact tonometry and ultra-high-speed camera (Corvis ST). Curr Eye Res 41:917–922. https://doi.org/10.3109/02713683.2015.1082185
Wan K, Cheung SW, Wolffsohn JS et al (2018) Role of corneal biomechanical properties in predicting of speed of myopic progression in children wearing orthokeratology lenses or single-vision spectacles. BMJ Open Ophthalmol 3:1–7. https://doi.org/10.1136/bmjophth-2018-000204
Nieto-Bona A, González-Mesa A, Villa-Collar C, Lorente-Velázquez A (2012) Biomechanical properties in corneal refractive therapy during adaptation period and after treatment interruption: a pilot study. J Optom 5:164–170. https://doi.org/10.1016/j.optom.2012.06.006
Liu WC, Lee SM, Graham AD, Lin MC (2011) Effects of eye rubbing and breath holding on corneal biomechanical properties and intraocular pressure. Cornea 30:855–860. https://doi.org/10.1097/ICO.0b013e3182032b21
Mazharian A, Panthier C, Courtin R et al (2020) Incorrect sleeping position and eye rubbing in patients with unilateral or highly asymmetric keratoconus: a case-control study. Graefe’s Arch Clin Exp Ophthalmol 258:2431–2439. https://doi.org/10.1007/s00417-020-04771-z
Morgan WH, Cunneen TS, Balaratnasingam C, Yu DY (2008) Wearing swimming goggles can elevate intraocular pressure. Br J Ophthalmol 92:1218–1221. https://doi.org/10.1136/bjo.2007.136754
Read SA, Collins MJ, Annis-Brown T et al (2011) The short-term influence of elevated intraocular pressure on axial length. Ophthalmic Physiol Opt 31:398–403. https://doi.org/10.1111/j.1475-1313.2011.00845.x
Jiménez R, Molina R, García JA et al (2020) Wearing swimming goggles reduces central corneal thickness and anterior chamber angle, and increases intraocular pressure. Curr Eye Res 45:535–541. https://doi.org/10.1080/02713683.2019.1662056
Matsuura M, Hirasawa K, Murata H et al (2017) The usefulness of CorvisST Tonometry and the Ocular Response Analyzer to assess the progression of glaucoma. Sci Rep 7:1–7. https://doi.org/10.1038/srep40798
Herber R, Ramm L, Spoerl E et al (2019) Assessment of corneal biomechanical parameters in healthy and keratoconic eyes using dynamic bidirectional applanation device and dynamic Scheimpflug analyzer. J Cataract Refract Surg 45:778–788. https://doi.org/10.1016/j.jcrs.2018.12.015
Serbecic N, Beutelspacher S, Markovic L et al (2019) Repeatability and reproducibility of corneal biomechanical parameters derived from Corvis ST. Eur J Ophthalmol. https://doi.org/10.1177/1120672119864554
Huseynova T, Waring GO IV, Roberts C et al (2014) Corneal biomechanics as a function of intraocular pressure and pachymetry by dynamic infrared signal and scheimpflug imaging analysis in normal eyes. Am J Ophthalmol 157:885–893. https://doi.org/10.1016/j.ajo.2013.12.024
Franz F, Edgar E, Albert-George L, Axel B (2007) Statistics textbooks in the. Behav Res Methods 39:175–191
National Health and Medical Research Council (2010) Guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma, pp 47–65
Paula APB, Paula JS, Silva MJL et al (2016) Effects of swimming goggles wearing on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude. J Glaucoma 25:860–864. https://doi.org/10.1097/IJG.0000000000000482
Joda AA, Shervin MMS, Kook D, Elsheikh A (2015) Development and validation of a correction equation for Corvis tonometry. Comput Methods Biomech Biomed Engin 19:943–953. https://doi.org/10.1080/10255842.2015.1077515
Starr CE, Radcliffe NM (2009) Swimming goggles and elevated intraocular pressure. Br J Ophthalmol 93:700. https://doi.org/10.1136/bjo.2008.152686
Kang MH, Morgan WH, Balaratnasingam C et al (2010) Case of normal tension glaucoma induced or exacerbated by wearing swimming goggles. Clin Exp Ophthalmol 38:428. https://doi.org/10.1111/j.1442-9071.2010.02259.x
Matsuura M, Murata H, Fujino Y et al (2020) Relationship between novel intraocular pressure measurement from Corvis ST and central corneal thickness and corneal hysteresis. Br J Ophthalmol 104:563–568. https://doi.org/10.1136/bjophthalmol-2019-314370
Miranda MA, Radhakrishnan H, O’Donnell C (2009) Repeatability of corneal thickness measured using an oculus pentacam. Optom Vis Sci 86:266–272. https://doi.org/10.1097/OPX.0b013e318196a737
Wu W, Wang Y, Xu L (2014) Meta-analysis of Pentacam vs. ultrasound pachymetry in central corneal thickness measurement in normal, post-LASIK or PRK, and keratoconic or keratoconus-suspect eyes. Graefe’s Arch Clin Exp Ophthalmol 252:91–99. https://doi.org/10.1007/s00417-013-2502-5
Tai LY, Khaw KW, Ng CM, Subrayan V (2013) Central corneal thickness measurements with different imaging devices and ultrasound pachymetry. Cornea 32:766–771. https://doi.org/10.1097/ICO.0b013e318269938d
Salvetat ML, Zeppieri M, Tosoni C et al (2015) Corneal deformation parameters provided by the corvis-st pachy-tonometer in healthy subjects and glaucoma patients. J Glaucoma 24:568–574. https://doi.org/10.1097/IJG.0000000000000133
Edmund C (1988) Corneal elasticity and ocular rigidity in normal and keratoconic eyes. Acta Ophthalmol 66:134–140. https://doi.org/10.1111/j.1755-3768.1988.tb04000.x
Meek KM (2008) The cornea and sclera. In: Springer (ed) Collagen. Boston, pp 359–396
Hatami-Marbini H, Etebu E (2013) An experimental and theoretical analysis of unconfined compression of corneal stroma. J Biomech 46:1752–1758
Hatami-Marbini H (2014) Viscoelastic shear properties of the corneal stroma. J Biomech 47:723–728. https://doi.org/10.1016/j.jbiomech.2013.11.019
Kamiya K, Shimizu K, Ohmoto F (2009) Effect of aging on corneal biomechanical parameters using the ocular response analyzer. J Refract Surg 25:888–893
Matalia J, Francis M, Tejwani S et al (2016) Role of age and myopia in simultaneous assessment of corneal and extraocular tissue stiffness by air-puff applanation. J Refract Surg 32:486–493. https://doi.org/10.3928/1081597X-20160512-02
Sergienko NM, Shargorogska I (2012) The scleral rigidity of eyes with different refractions. Graefe’s Arch Clin Exp Ophthalmol 250:1009–1012. https://doi.org/10.1007/s00417-012-1973-0
Orucoglu F, Akman M, Onal S (2015) Analysis of age, refractive error and gender related changes of the cornea and the anterior segment of the eye with Scheimpflug imaging. Contact Lens Anterior Eye 38:345–350. https://doi.org/10.1016/j.clae.2015.03.009
Xu L, Cao WF, Wang YX et al (2008) Anterior chamber depth and chamber angle and their associations with ocular and general parameters: the Beijing Eye Study. Am J Ophthalmol 145:929–936. https://doi.org/10.1016/j.ajo.2008.01.004
Wang W, Du S, Zhang X (2015) Corneal deformation response in patients with primary open-angle glaucoma and in healthy subjects analyzed by Corvis ST. Invest Ophthalmol Vis Sci 56:5557–5565. https://doi.org/10.1167/iovs.15-16926
Sedaghat MR, Momeni-Moghaddam H, Ambrósio R et al (2018) Diagnostic ability of corneal shape and biomechanical parameters for detecting frank keratoconus. Cornea 37:1025–1034. https://doi.org/10.1097/ICO.0000000000001639
Acknowledgements
The authors thank all the participants who selflessly collaborated in this research.
Funding
Funding for open access charge: Universidad de Granada / CBUA. The authors have no financial or proprietary interest in a product, method or material described herein. The article has not been presented in a meeting.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interests
The authors have not disclosed any competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Jiménez, R., Molina, R., Vera, J. et al. The short-term effects of wearing swimming goggles on corneal biomechanics. Int Ophthalmol 42, 2773–2784 (2022). https://doi.org/10.1007/s10792-022-02268-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-022-02268-8