Evaluation of the effect of subepithelial infiltrates following adenoviral keratoconjunctivitis on corneal biomechanics: Corvis ST analysis

BACKGROUND: The purpose of this study was to evaluate the impact of subepithelial infiltrates (SEIs) developing after adenovirus epidemic keratoconjunctivitis (EKC) on corneal densitometry and biomechanical properties. METHODS: Patients who were followed up for at least six months after an acute EKC episode and had persistent SEI were included in the study. Ophthalmological examination findings, corneal tomographic and densitometric parameters obtained with the Pentacam AXL Wave, and biomechanical measurements acquired with the Corvis ST were recorded. RESULTS: Twenty-three eyes of 12 patients with SEIs after EKC and 32 eyes of 16 healthy controls were analyzed, with no significant differences in age or sex distribution between groups. The EKC group showed worse BCVA, higher K2 and Kmax values, increased total higher-order aberrations (HOAs), and elevated corneal densitometry, predominantly in the anterior and central zones. Among biomechanical parameters, A1-length was significantly lower in the EKC group, whereas the remaining biomechanical and specular microscopy parameters were similar between groups. Within the EKC group, extensive involvement was associated with thinner corneas, greater HOAs, and higher central corneal densitometry values. CONCLUSION: Eyes with persistent SEIs after EKC exhibited increased corneal densitometry, whereas alterations in selected biomechanical parameters were limited. These findings may reflect post-inflammatory corneal remodeling. Because only A1-length remained significantly associated with EKC after multivariable adjustment, the biomechanical findings should be interpreted cautiously. Careful preoperative corneal evaluation is advisable for refractive surgery candidates with persistent SEIs after EKC.