Sleep deprivation and corneal chronobiology: reevaluating overnight corneal changes.

This prospective cohort study is aimed to investigate circadian variations in corneal parameters, focusing on sleep-deprived subjects. Sixty-four healthy individuals (age range: 21-76 years) actively participated in this study, undergoing examinations at least five times within a 24-hour timeframe. The analysis encompassed keratometric parameters of the cornea's front (F) and back (B) surfaces, refractive power in flattest and steepest axes (K1, K2), astigmatism (Astig) and its axis (Axis), aspheric coefficient (Asph), corneal pachymetry values of thinnest corneal thickness (Pachy Min) and corneal thickness in the center of the pupil (Pachy Pupil), volume relative to the 3 and 10 mm corneal diagonal (Vol D3, Vol D10) and surface variance index (ISV). Circadian changes were assessed using a hierarchical, mixed-effects linear regression adjusted for age and night shift. A total of 1,636 measurements revealed significant circadian changes in various corneal parameters, including K1 F, K2 F/B, Astig F/B, Asph F/B, Pachy Min/Pupil, Vol D3/10, and ISV (p < 0.0001). Moreover, K1 B exhibited a significant circadian change (p = 0.0002), while Axis F/B remained unchanged. Notably, Corneal thickness peaked before 6 o'clock in the morning and reached its minimum after 12 o'clock. Contrary to previous notions linking corneal diurnal changes with eyelid closure during sleep, our study reveals that these changes persist in the absence of sleep. This research contributes valuable insights into the impact of sleep deprivation on corneal properties, warranting further investigations to deepen our understanding of daily variations in visual quality and guide the planning of refractive eye surgery interventions.