Objective To investigate the correlation of corneal biomechanical parameters with ocular aberrations as well as corneal anterior surface aberrations in patients with myopia.

Methods A total of 95 patients (190 eyes) with myopia were selected as study subjects. Ocular aberrations and corneal anterior surface aberrations were measured, and the total root mean square (RMS) and root mean square of high order aberration(RMSh) were recorded. Corneal biomechanical parameters, including central corneal thickness (CCT), intraocular pressure (IOP), Goldmann-correlated IOP (IOPg), corneal-compensated intraocular pressure (IOPcc), corneal hysteresis (CH), and corneal resistance factor (CRF) were also measured. The corneal biomechanical parameters, total RMS, and total RMSh were compared among patients with different degrees of myopia. Pearson correlation analysis was used to assess the correlations of corneal biomechanical parameters with ocular and corneal anterior surface high-order aberrations (coma and spherical aberration).

Results The corneal anterior surface aberrations (total RMS and total RMSh) in both left and right eyes of the 95 patients were greater than the ocular aberrations(P < 0.05). The total RMS of both the ocular and corneal anterior surfaces was higher in patients with high myopia compared to those with moderate and low myopia, and was also higher in patients with moderate myopia compared to those with low myopia (P < 0.05). Correlation analysis revealed there were strong positive correlations of IOP with the spherical aberration of both the ocular and corneal anterior surfaces in patients with low and moderate myopia (P < 0.01), as well as a strong positive correlation between IOP and the ocular aberrations in patients with high myopia(P < 0.01). IOPg showed strong positive correlations with the ocular aberrations in patients with low, moderate, and high myopia (P < 0.01), as well as a strong positive correlation with the corneal anterior surface spherical aberration in patients with moderate myopia (P < 0.01). IOPcc was positively correlated with the ocular aberrations in patients with low and moderate myopia (P < 0.05). CRF and CH were positively separately correlated with the spherical aberration of both the ocular and corneal anterior surfaces in patients with low and moderate myopia (P < 0.05), and positively correlated with the ocular aberrations in patients with high myopia (P < 0.05).

Conclusion The ocular aberrations in patients with myopia are typically smaller than the corneal anterior surface aberrations. IOP, IOPg, and IOPcc are all correlated with ocular aberrations, and the correlation between corneal biomechanical parameters and high-order aberrations is stronger in patients with low myopia compared to those with moderate and high myopia.