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Background   To evaluate and compare corneal hysteresis (CH) and corneal resistance factor (CRF) in normal thin (NT) healthy corneas with central corneal thickness (CCT) of 470–500  μ m with matched thickness in keratoconus suspect (KCS) and keratoconus (KC) eyes.Methods   A total of 103 eyes in three groups were included prospectively: NT, KCS, and KC groups based on clinical examination and Pentacam findings. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using the ocular response analyzer (ORA). CCT, CH, and CRF were compared between the three groups and statistically analyzed by variance tests.Results   The three groups consisted of 44 NT, 26 KCS, and 33 KC. The mean CH measured was 8.689 ± 1.775, 9.051 ± 1.1190, and 8.129 ± 0.8539 mmHg in NT, KCS, and KC eyes, respectively. The mean CRF was 8.441 ± 1.663, 8.337 ± 1.114, and 7.2422 ± 1.3110 mmHg in NT, KCS, and KC eyes, respectively. Within the range of central corneal thickness (470–500  μ m), only mean CRF was statistically significantly different between the NT and KC ( P  < 0.05); there was no statistically significant difference between NT and KCS, nor was the mean CH between each group ( P  > 0.05).Conclusions   CRF only can be helpful in differentiating KC from NT eyes; KCS could not be predicted with either corneal biomechanical metrics. There was no benefit from CH in differentiating between the three study groups.

Biomechanical Properties in Different Types of Thin Corneas in Menoufia Population