{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T04:01:42Z","timestamp":1745899302682,"version":"3.40.4"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Fundamental Fund 2567 from Chiang Mai University, Thailand","award":["2567A10412075","2567A10412075"],"award-info":[{"award-number":["2567A10412075","2567A10412075"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Current evidence suggests allergic conjunctivitis and contact lens use may affect corneal biomechanics, but the relationship between conjunctival changes and biomechanical abnormalities remains unclear. This study aimed to determine whether upper tarsal conjunctival roughness and redness are associated with corneal biomechanical weakening in refractive surgery candidates without ectatic corneal disease. Conducted at Chiang Mai University LASIK Center between July 2023 and January 2024, conjunctival roughness and redness were graded using the Institute for Eye Research (IER) scales, while corneal biomechanics were assessed through Corvis parameters. The study included 434 eyes from 217 participants (70.5% female), with a mean age of 33.4 years (SD 8.3). Ocular allergy was reported by 23.0% (50\/217) of participants, and 54.4% (236\/434) had a history of contact lens use. The median conjunctival roughness score was 2 (IQR 0, 5). Conjunctival roughness score was positively correlated with biomechanical indices, particularly the deformation amplitude (DA) ratio (coefficient 0.009, 95% confidence interval 0.001 to 0.017, <jats:italic>p<\/jats:italic>\u2009=\u2009.04), suggesting weakened biomechanical property. No significant association was found between conjunctival redness and corneal biomechanics. In conclusion, upper tarsal roughness may associate with biomechanical weakening of the cornea, though these changes were insufficient to significantly affect the Corvis Biomechanical Index (CBI).<\/jats:p>","DOI":"10.1038\/s41598-025-00122-2","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T08:22:25Z","timestamp":1745828545000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between upper tarsal conjunctiva appearance and corneal biomechanical weakening in refractive surgery candidates"],"prefix":"10.1038","volume":"15","author":[{"given":"Phit","family":"Upaphong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Napaporn","family":"Tananuvat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muanploy","family":"Niparugs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janejit","family":"Choovuthayakorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chulaluck","family":"Tangmonkongvoragul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somsanguan","family":"Ausayakhun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winai","family":"Chaidaroon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"122_CR1","doi-asserted-by":"publisher","first-page":"2313","DOI":"10.3390\/life13122313","volume":"13","author":"A L\u00f3pez-Mu\u00f1oz","year":"2023","unstructured":"L\u00f3pez-Mu\u00f1oz, A., L\u00f3pez-Casta\u00f1o, I., Torres-Parejo, \u00da. & Garc\u00eda-Romera, M. C. A corneal Biomechanical study measured with a Scheimpflug dynamic analyser in soft contact Lens wearers. Life 13, 2313 (2023).","journal-title":"Life"},{"key":"122_CR2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1097\/j.jcrs.0000000000000740","volume":"48","author":"E Flockerzi","year":"2022","unstructured":"Flockerzi, E. et al. Correlation of the corvis biomechanical factor with tomographic parameters in keratoconus. J. Cataract Refract. Surg. 48, 215\u2013221. https:\/\/doi.org\/10.1097\/j.jcrs.0000000000000740 (2022).","journal-title":"J. Cataract Refract. Surg."},{"key":"122_CR3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1097\/ico.0000000000002129","volume":"39","author":"S Koh","year":"2020","unstructured":"Koh, S. et al. Correlation between corneal biomechanical indices and the severity of keratoconus. Cornea 39, 215\u2013221. https:\/\/doi.org\/10.1097\/ico.0000000000002129 (2020).","journal-title":"Cornea"},{"key":"122_CR4","doi-asserted-by":"publisher","first-page":"108347","DOI":"10.1016\/j.exer.2020.108347","volume":"202","author":"MQ Salom\u00e3o","year":"2021","unstructured":"Salom\u00e3o, M. Q. et al. Ectatic diseases. Exp. Eye Res. 202 108347 (2021).","journal-title":"Exp. Eye Res."},{"key":"122_CR5","doi-asserted-by":"publisher","first-page":"164","DOI":"10.2174\/1874364101812010164","volume":"12","author":"IB Damgaard","year":"2018","unstructured":"Damgaard, I. B., Reffat, M. & Hjortdal, J. Review of corneal biomechanical properties following LASIK and SMILE for myopia and myopic astigmatism. open. Ophthalmol. J. 12, 164\u2013174. https:\/\/doi.org\/10.2174\/1874364101812010164 (2018).","journal-title":"open. Ophthalmol. J."},{"key":"122_CR6","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.oftale.2022.07.003","volume":"98","author":"J Ortega-Usobiaga","year":"2023","unstructured":"Ortega-Usobiaga, J., Rocha-de-Lossada, C., Llovet-Rausell, A. & Llovet-Osuna, F. Update on contraindications in laser corneal refractive surgery. Arch. Soc. Esp. Oftalmol (Engl Ed). 98, 105\u2013111. https:\/\/doi.org\/10.1016\/j.oftale.2022.07.003 (2023).","journal-title":"Arch. Soc. Esp. Oftalmol (Engl Ed)"},{"key":"122_CR7","doi-asserted-by":"publisher","first-page":"803","DOI":"10.3928\/1081597X-20160629-01","volume":"32","author":"R Vinciguerra","year":"2016","unstructured":"Vinciguerra, R. et al. Detection of keratoconus with a new biomechanical index. J. Refract. Surg. 32, 803\u2013810. https:\/\/doi.org\/10.3928\/1081597X-20160629-01 (2016).","journal-title":"J. Refract. Surg."},{"key":"122_CR8","doi-asserted-by":"publisher","first-page":"434","DOI":"10.3928\/1081597x-20170426-02","volume":"33","author":"R Ambr\u00f3sio Jr","year":"2017","unstructured":"Ambr\u00f3sio, R. Jr. et al. Integration of Scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection. J. Refract. Surg. 33, 434\u2013443. https:\/\/doi.org\/10.3928\/1081597x-20170426-02 (2017).","journal-title":"J. Refract. Surg."},{"key":"122_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s12938-019-0636-3","author":"M J\u0119dzierowska","year":"2019","unstructured":"J\u0119dzierowska, M. & Koprowski, R. Novel dynamic corneal response parameters in a practice use: A critical review. Biomed. Eng. Online. https:\/\/doi.org\/10.1186\/s12938-019-0636-3 (2019).","journal-title":"Biomed. Eng. Online"},{"key":"122_CR10","first-page":"2013","volume":"6","author":"B Mohd Ali","year":"2014","unstructured":"Mohd Ali, B., Poh, T., Boptom, J., Ishak, B. & Mohidin, N. Changes in the appearance of tarsal conjunctiva in soft contact lens wearers in Kuala Lumpur. Int. J. Collaborative Res. Intern. Med. Public. Health. 6, 2013\u20132018 (2014).","journal-title":"Int. J. Collaborative Res. Intern. Med. Public. Health"},{"key":"122_CR11","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.jtos.2019.10.002","volume":"18","author":"R Salinas","year":"2020","unstructured":"Salinas, R., Puig, M., Fry, C. L., Johnson, D. A. & Kheirkhah, A. Floppy eyelid syndrome: A comprehensive review. Ocul. Surf. 18, 31\u201339. https:\/\/doi.org\/10.1016\/j.jtos.2019.10.002 (2020).","journal-title":"Ocul. Surf."},{"key":"122_CR12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s40662-021-00241-7","volume":"8","author":"Q Wang","year":"2021","unstructured":"Wang, Q. et al. Corneal Biomechanical changes in allergic conjunctivitis. Eye Vis. (Lond). 8, 17. https:\/\/doi.org\/10.1186\/s40662-021-00241-7 (2021).","journal-title":"Eye Vis. (Lond)"},{"key":"122_CR13","doi-asserted-by":"publisher","first-page":"131","DOI":"10.4103\/2008-322X.183921","volume":"11","author":"S Radaie-Moghadam","year":"2016","unstructured":"Radaie-Moghadam, S., Hashemi, H., Jafarzadehpur, E., Yekta, A. A. & Khabazkhoob, M. Corneal Biomechanical changes following toric soft contact Lens wear. J. Ophthalmic Vis. Res. 11, 131\u2013135. https:\/\/doi.org\/10.4103\/2008-322X.183921 (2016).","journal-title":"J. Ophthalmic Vis. Res."},{"key":"122_CR14","doi-asserted-by":"publisher","first-page":"5603763","DOI":"10.1155\/2016\/5603763","volume":"2016","author":"F Alipour","year":"2016","unstructured":"Alipour, F. et al. Corneal biomechanical findings in contact lens induced corneal warpage. J. Ophthalmol. 2016, 5603763. https:\/\/doi.org\/10.1155\/2016\/5603763 (2016).","journal-title":"J. Ophthalmol."},{"key":"122_CR15","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/ico.0000000000000396","volume":"34","author":"M Muniesa","year":"2015","unstructured":"Muniesa, M. et al. Corneal biomechanical properties in floppy eyelid syndrome. Cornea 34, 521\u2013524. https:\/\/doi.org\/10.1097\/ico.0000000000000396 (2015).","journal-title":"Cornea"},{"key":"122_CR16","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1097\/ACI.0000000000000571","volume":"19","author":"H Ben-Eli","year":"2019","unstructured":"Ben-Eli, H., Erdinest, N. & Solomon, A. Pathogenesis and complications of chronic eye rubbing in ocular allergy. Curr. Opin. Allergy Clin. Immunol. 19, 526\u2013534. https:\/\/doi.org\/10.1097\/ACI.0000000000000571 (2019).","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"122_CR17","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.jfo.2020.06.050","volume":"44","author":"A Peyman","year":"2021","unstructured":"Peyman, A. et al. Corneal biomechanical properties after soft contact lens wear measured on a dynamic Scheimpflug analyzer: A before and after study. J. Fr. Ophtalmol. 44, 391\u2013396. https:\/\/doi.org\/10.1016\/j.jfo.2020.06.050 (2021).","journal-title":"J. Fr. Ophtalmol."},{"key":"122_CR18","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1167\/iovs.04-0913","volume":"46","author":"DTS Liu","year":"2005","unstructured":"Liu, D. T. S., Di Pascuale, M. A., Sawai, J., Gao, Y. Y. & Tseng, S. C. G. Tear film dynamics in floppy eyelid syndrome. Investig. Ophthalmol. Vis. Sci. 46, 1188\u20131194. https:\/\/doi.org\/10.1167\/iovs.04-0913 (2005).","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"122_CR19","first-page":"2374","volume-title":"Contact Lenses","author":"A Phillips","year":"2019","unstructured":"Phillips, A., Speedwell, L. & Hough, T. Contact Lenses 2374 (Elsevier, 2019)."},{"key":"122_CR20","doi-asserted-by":"publisher","DOI":"10.2174\/18743641-v16-e2204051","author":"P Upaphong","year":"2022","unstructured":"Upaphong, P. et al. Comorbidities in corneal refractive surgery candidates: A cross-sectional study. Open. Ophthalmol. J. https:\/\/doi.org\/10.2174\/18743641-v16-e2204051 (2022).","journal-title":"Open. Ophthalmol. J."},{"key":"122_CR21","doi-asserted-by":"publisher","first-page":"418","DOI":"10.3109\/09273948.2016.1145697","volume":"25","author":"M Naderan","year":"2017","unstructured":"Naderan, M., Rajabi, M. T., Zarrinbakhsh, P. & Bakhshi, A. Effect of allergic diseases on keratoconus severity. Ocul. Immunol. Inflamm. 25, 418\u2013423. https:\/\/doi.org\/10.3109\/09273948.2016.1145697 (2017).","journal-title":"Ocul. Immunol. Inflamm."},{"key":"122_CR22","doi-asserted-by":"publisher","first-page":"4940","DOI":"10.1038\/s41598-023-32176-5","volume":"13","author":"R Antunes-Foschini","year":"2023","unstructured":"Antunes-Foschini, R. et al. Natural history and predictors for progression in pediatric keratoconus. Sci. Rep. 13, 4940. https:\/\/doi.org\/10.1038\/s41598-023-32176-5 (2023).","journal-title":"Sci. Rep."},{"key":"122_CR23","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.ophtha.2019.02.029","volume":"126","author":"AC Ferdi","year":"2019","unstructured":"Ferdi, A. C. et al. Keratoconus natural progression: A systematic review and Meta-analysis of 11 529 eyes. Ophthalmology 126, 935\u2013945. https:\/\/doi.org\/10.1016\/j.ophtha.2019.02.029 (2019).","journal-title":"Ophthalmology"},{"key":"122_CR24","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/BF02477784","volume":"31","author":"RA Farrell","year":"1969","unstructured":"Farrell, R. A. & Hart, R. W. On the theory of the spatial organization of macromolecules in connective tissue. Bull. Math. Biophys. 31, 727\u2013760. https:\/\/doi.org\/10.1007\/BF02477784 (1969).","journal-title":"Bull. Math. Biophys."},{"key":"122_CR25","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.1097\/ICO.0000000000000527","volume":"34 9","author":"GD Kymionis","year":"2015","unstructured":"Kymionis, G. D. & Tsoulnaras, K. I. Corneal biomechanical properties in floppy eyelid syndrome. Cornea 34 9, e29 (2015).","journal-title":"Cornea"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-00122-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-00122-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-00122-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T08:22:26Z","timestamp":1745828546000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-00122-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["122"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-00122-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"assertion":[{"value":"19 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14793"}}