Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Smoking, alcohol consumption and corneal biomechanical parameters among Chinese university students

Eye (2023)Cite this article

Subjects

Abstract

Background/Objectives

Smoking and alcohol consumption are important risk factors for several ocular disorders, but their effects on corneal biomechanics remain unclear. Our study aims to explore the association between smoking and alcohol consumption with corneal biomechanical parameters measured by Corvis-ST (CST) among university students.

Subjects/Methods

A total of 1645 healthy university students from a university-based study were included, and all participants underwent corneal biomechanical parameters measurement by CST. We selected 10 reliable parameters that can reflect the corneal deformation response. All participants had a standardised interview to determine their smoking and alcohol consumption status.

Results

The mean age of the participants was 19.0 ± 0.9 years, and 1132 (68.8%) were women. Smoking was significantly associated with stiffer corneas. Smokers showed significantly slower second applanation velocity (A2v) (β = 0.007 m/s, 95% confidence interval 0.001 to 0.014, P = 0.032) and lower integrated radius (IR) (β = −0.214 mm−1, 95% confidence interval −0.420 to −0.007, P = 0.043) than non-smokers after adjusting for age, gender, eye-rubbing, myopia, and body mass index (BMI). Smokers with BMI no less than 24.0 showed slower A2v and lower IR. Alcohol consumption and passive smoking were found no significant association with corneal biomechanics.

Conclusion

Smokers had less deformable corneas, especially those with BMI no less than 24.0. Our findings provide new evidence for the association between smoking and ocular disorders associated with corneal biomechanics like glaucoma.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: The β coefficient of multivariate linear regression for the association between smoking frequency and corneal biomechanics.
Fig. 2: Three-dimensional bar charts showing the mean corneal biomechanical parameters stratified according to smoking status and BMI.

Data availability

The data that support the findings of this study are available upon reasonable request.

References

  1. Ruberti JW, Sinha Roy A, Roberts CJ. Corneal biomechanics and biomaterials. Annu Rev Biomed Eng. 2011;13:269–95.

    Article  CAS  Google Scholar 

  2. Wang W, Du S, Zhang X. Corneal deformation response in patients with primary open-angle glaucoma and in healthy subjects analyzed by corvis ST. Investig Ophthalmol Vis Sci. 2015;56:5557–65.

    Article  Google Scholar 

  3. Bao F, Geraghty B, Wang Q, Elsheikh A. Consideration of corneal biomechanics in the diagnosis and management of keratoconus: is it important? Eye Vis. 2016;3:18.

    Article  Google Scholar 

  4. Dackowski EK, Lopath PD, Chuck RS. Preoperative, intraoperative, and postoperative assessment of corneal biomechanics in refractive surgery. Curr Opin Ophthalmol. 2020;31:234–40.

    Article  Google Scholar 

  5. Kling S, Hafezi F. Corneal biomechanics - a review. Ophthalmic Physiol Opt. 2017;37:240–52.

    Article  Google Scholar 

  6. Spoerl E, Zubaty V, Raiskup-Wolf F, Pillunat LE. Oestrogen-induced changes in biomechanics in the cornea as a possible reason for keratectasia. Br J Ophthalmol. 2007;91:1547–50.

    Article  Google Scholar 

  7. Hafezi F. Smoking and corneal biomechanics. Ophthalmology. 2009;116:2259.e1.

    Article  Google Scholar 

  8. Olsen EG, Olsen H. Influence of ethanol ingestion on the cornea. Acta Ophthalmol. 1993;71:696–8.

    Article  CAS  Google Scholar 

  9. Liu WC, Lee SM, Graham AD, Lin MC. Effects of eye rubbing and breath holding on corneal biomechanical properties and intraocular pressure. Cornea. 2011;30:855–60.

    Article  Google Scholar 

  10. Cankaya AB, Beyazyildiz E, Ileri D, Ozturk F. The effect of contact lens usage on corneal biomechanical parameters in myopic patients. Cornea. 2012;31:764–9.

    Article  Google Scholar 

  11. Schweitzer C, Korobelnik JF, Boniol M, Cougnard-Gregoire A, Le Goff M, Malet F, et al. Associations of Biomechanical properties of the cornea with environmental and metabolic factors in an elderly population: the ALIENOR study. Investig Ophthalmol Vis Sci. 2016;57:2003–11.

    Article  CAS  Google Scholar 

  12. Spoerl E, Raiskup-Wolf F, Kuhlisch E, Pillunat LE. Cigarette smoking is negatively associated with keratoconus. J Refract Surg. 2008;24:S737–40.

    Google Scholar 

  13. Zhang B, Shweikh Y, Khawaja AP, Gallacher J, Bauermeister S, Foster PJ, et al. Associations with corneal hysteresis in a population cohort: results from 96 010 UK Biobank participants. Ophthalmology. 2019;126:1500–10.

    Article  Google Scholar 

  14. Kilavuzoglu AE, Celebi AR, Altiparmak UE, Cosar CB. The effect of smoking on corneal biomechanics. Curr Eye Res. 2017;42:16–20.

    Article  Google Scholar 

  15. Wollensak G, Spoerl E. Collagen crosslinking of human and porcine sclera. J Cataract Refract Surg. 2004;30:689–95.

    Article  Google Scholar 

  16. Altinors DD, Akça S, Akova YA, Bilezikçi B, Goto E, Dogru M, et al. Smoking associated with damage to the lipid layer of the ocular surface. Am J Ophthalmol. 2006;141:1016–21.

    Article  CAS  Google Scholar 

  17. Matsumoto Y, Dogru M, Goto E, Sasaki Y, Inoue H, Saito I, et al. Alterations of the tear film and ocular surface health in chronic smokers. Eye. 2008;22:961–8.

    Article  CAS  Google Scholar 

  18. Sati A, Moulick P, Shankar S, Chatterjee K, Dwivedi AK, Vazirani J. Corneal endothelial alterations in alcohol dependence syndrome. Br J Ophthalmol. 2018;102:1443–7.

    Article  Google Scholar 

  19. Menéndez-Acebal C, Martínez-González MA, Bes-Rastrollo M, Moreno-Montañés J, García-Layana A, Gea A. The influence of alcohol intake in myopia development or progression: the SUN cohort study. Drug Alcohol Depend. 2021;229:109149.

    Article  Google Scholar 

  20. Koprowski R. Automatic method of analysis and measurement of additional parameters of corneal deformation in the Corvis tonometer. Biomed Eng Online. 2014;13:150.

    Article  Google Scholar 

  21. Roberts CJ, Mahmoud AM, Bons JP, Hossain A, Elsheikh A, Vinciguerra R, et al. Introduction of two novel stiffness parameters and interpretation of air puff-induced biomechanical deformation parameters with a dynamic scheimpflug analyzer. J Refract Surg. 2017;33:266–73.

    Article  Google Scholar 

  22. Ferreira-Mendes J, Lopes BT, Faria-Correia F, Salomão MQ, Rodrigues-Barros S, Ambrósio R Jr. Enhanced ectasia detection using corneal tomography and biomechanics. Am J Ophthalmol. 2019;197:7–16.

    Article  Google Scholar 

  23. Wang M, Luo X, Xu S, Liu W, Ding F, Zhang X, et al. Trends in smoking prevalence and implication for chronic diseases in China: serial national cross-sectional surveys from 2003 to 2013. Lancet Respir Med. 2019;7:35–45.

    Article  Google Scholar 

  24. Newman I, Ding L, Feng Y. Estimate of undergraduate university student alcohol use in China: a systematic review and meta-analysis. Arch Public Health. 2017;75:52. -

    Article  Google Scholar 

  25. Flockerzi E, Häfner L, Xanthopoulou K, Daas L, Munteanu C, Langenbucher A, et al. Reliability analysis of successive Corneal Visualization Scheimpflug Technology measurements in different keratoconus stages. Acta Ophthalmol. 2022;100:e83–e90.

    Article  Google Scholar 

  26. Ali NQ, Patel DV, McGhee CN. Biomechanical responses of healthy and keratoconic corneas measured using a noncontact scheimpflug-based tonometer. Investig Ophthalmol Vis Sci. 2014;55:3651–9.

    Article  Google Scholar 

  27. Xu Y, Ye Y, Chong IT, Chen Z, Xu J, Yang Y, et al. A novel indentation assessment to measure corneal biomechanical properties in glaucoma and ocular hypertension. Transl Vis Sci Technol. 2021;10:36.

    Article  Google Scholar 

  28. Sayin N. A comparison of corneal biomechanical properties of chronic smokers and non-smokers using the ocular response analyzer. Adv Ophthalmol Vis Syst. 2015;2:00027.

    Google Scholar 

  29. Paik DC, Saito LY, Sugirtharaj DD, Holmes JW. Nitrite-induced cross-linking alters remodeling and mechanical properties of collagenous engineered tissues. Connect Tissue Res. 2006;47:163–76.

    Article  CAS  Google Scholar 

  30. Wolffenbuttel BH, Boulanger CM, Crijns FR, Huijberts MS, Poitevin P, Swennen GN, et al. Breakers of advanced glycation end products restore large artery properties in experimental diabetes. Proc Natl Acad Sci USA. 1998;95:4630–4.

    Article  CAS  Google Scholar 

  31. Ruiz HH, Ramasamy R, Schmidt AM. Advanced glycation end products: building on the concept of the “common soil” in metabolic disease. Endocrinology. 2020;161:bqz006.

    Article  Google Scholar 

  32. Jain V, Jain M, Abdull MM, Bastawrous A. The association between cigarette smoking and primary open-angle glaucoma: a systematic review. Int Ophthalmol. 2017;37:291–301.

    Article  Google Scholar 

  33. Hondur G, Göktas E, Yang X, Al-Aswad L, Auran JD, Blumberg DM, et al. Oxidative stress–related molecular biomarker candidates for glaucoma. Investig Opthalmol Vis Sci. 2017;58:4078–88.

    Article  CAS  Google Scholar 

  34. Kandarakis SA, Piperi C, Topouzis F, Papavassiliou AG. Emerging role of advanced glycation-end products (AGEs) in the pathobiology of eye diseases. Prog Retin Eye Res. 2014;42:85–102.

    Article  CAS  Google Scholar 

Download references

Funding

This study is funded by National Natural Science Foundation of China (82160204)

Author information

Authors and Affiliations

  1. School of Public Health, Medical College of Soochow University, Suzhou, China

    Min-Xin Liu, Dan-Lin Li & Chen-Wei Pan

  2. Department of Ophthalmology, The First Affiliated Hospital of Dali University, Dali, China

    Zhi-Jian Yin

  3. Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China

    Yue-Zu Li, Ya-Jie Zheng, Yu Qin & Gang Liang

  4. Department of Ophthalmology, The Second People’s Hospital of Yunnan Province, Kunming, China

    Yue-Zu Li, Ya-Jie Zheng, Yu Qin & Gang Liang

Authors
  1. Min-Xin Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dan-Lin Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhi-Jian Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yue-Zu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ya-Jie Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gang Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chen-Wei Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The authors confirm contribution to the paper as follows. Study conception and design: CWP, GL. Data collection: MXL, DLL, ZJY, YZL, YJZ, YQ. Data analysis and interpretation: MXL, DLL, YZL; Paper writing: MXL, CWP. Final approval of paper: all authors.

Corresponding authors

Correspondence to Gang Liang or Chen-Wei Pan.

Ethics declarations

Competing interests

The authors declared no 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

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Liu, MX., Li, DL., Yin, ZJ. et al. Smoking, alcohol consumption and corneal biomechanical parameters among Chinese university students. Eye (2023). https://doi.org/10.1038/s41433-023-02405-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41433-023-02405-2

Search

Advanced search

Quick links