PURPOSE: To investigate the relationship between serum biochemical variables and corneal biomechanics in healthy young adults. METHODS: A total of 1645 healthy university students were included. Every student underwent an ophthalmologic examination by Corvis ST to measure the corneal biomechanics and a blood examination to evaluate the alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, creatinine, and uric acid (UA) levels. Canonical correlation analysis (CCA) was conducted to assess their relationship. RESULTS: A significant relationship between serum biochemical variables and corneal biomechanics was found in both men and women. For men, the canonical correlation identified an association between the time of the first applanation (A1t), time of the second applanation (A2t), time of the highest concavity (HC-t), deflection amplitude of the highest concavity (HC-DeflA), and biomechanically corrected intraocular pressure (bIOP) with ALT, AST, urea, and UA (r = 0.235, P = 0.03). For women, a significant relationship between A1t, A2t, and bIOP with ALT and UA was found (r = 0.187, P <
0.01). CONCLUSIONS: Elevated levels of ALT and UA were associated with softer corneas with greater elasticity and viscidity. The study provides novel evidence for the relationship between serum biochemical variables and ocular changes. TRANSLATIONAL RELEVANCE: These findings may help clinicians perform adequate preoperative evaluations when performing corneal surgery on patients with liver or kidney disorders, as well as helping public health practitioners understand serum biochemical variables of corneal changes in healthy people.