For a study, it was determined that corneal striae were shown to have a steeper cornea, induced astigmatism, and increased corneal hysteresis (CH), which indicated a link between striae, corneal morphology, and the cornea’s resistance to deformation at low intraocular pressures (IOPs). Low IOP was linked to anterior corneal striae (ACS). The clinical significance of ACS, on the other hand, remains unknown. The researchers sought to compare the differences between eyes with and without striae for a study. Adults with ACS (cases) and without ACS (controls) were included 8 weeks following glaucoma surgery with an IOP of less than or equal to 10 mm Hg. Optical biometry and optical coherence tomography were used. The ocular response analyzer measured CH, defined as the pressure difference between corneal indentation and reformation in reaction to an air jet. Optic disc enlargement, vascular tortuosity due to hypotony, or clinical appearance of chorioretinal folds verified by OCT were characterized as hypotony maculopathy (HM). A total of 116 eyes (76 cases and 40 controls) were used in the study. Compared to controls, cases showed a lower IOP (6.5±2.3 vs 8.5±1, P<0.0001). CH increased the risks of ACS by 1 mm Hg [odds ratio (OR)=1.51, P=0.01]. The risks of ACS increased by 1.83 (P=0.01) and 1.41 (P=0.02), respectively, when the flattest presurgical and postsurgical corneal power was increased by 1 D. Astigmatism rose by 1.11 D in eyes treated with ACS (P<0.001). The use of topical glaucoma medicine (OR=0.62, P=0.03) was associated with a higher risk of ACS (OR=1.58, P=0.047) and a lower risk of ACS (OR=0.62, P=0.03). The logarithm of the minimal angle of resolution decreased from 0.22 (20/33 Snellen) presurgery to 0.28 (20/38) postsurgery (P=0.008), regardless of ACS. HM was found in 19% of the patients (P=0.05). Higher postsurgical CH was associated with a higher risk of HM (OR=1.8, P=0.003). HM predicted a 0.41 mm decrease in axial length (P<0.0001), independent of IOP. The presence of ACS was linked to a steeper cornea, induced astigmatism, and more significant CH, implying a link between striae, corneal shape, and the cornea’s ability to tolerate deformations at low IOP. Independent of IOP, CH, HM, and axial length shortening were linked.