Purpose. To compare the corneal biomechanical properties of keratoconic patients and age-matched controls using corneal visualization Scheimpflug technology (Corvis ST). Methods. Sixty keratoconic eyes from 47 keratoconus patients and 60 normal eyes from 60 controls were enrolled in this prospective study. Tomography and biomechanical parameters of all eyes were obtained with the Pentacam and Corvis ST, respectively. Intraocular pressure was measured using a Goldmann applanation tonometer. Results. The tomography and biomechanical parameters of the keratoconic corneas were significantly different from those of the normal corneas except for the anterior chamber angle, first applanation length, the highest concavity time, and peak distance. The deformation amplitude was the best predictive parameter (area under the curve: 0.882), with a sensitivity of 81.7%, although there was a significant overlap between keratoconic and normal corneas that ranged from 1.0 to 1.4 mm. In both the keratoconus and control groups, the deformation amplitude was negatively correlated with intraocular pressure, central corneal thickness, and corneal volume at 3 and 5 mm. Conclusions. Corvis ST offers an alternative method for measuring corneal biomechanical properties. The possibility of classifying keratoconus based on deformation amplitude deserves clinical attention.

ABSTRACT.Purpose: To evaluate the biomechanical properties of the cornea using Corneal Visualization Scheimpflug Technology (CorVis ST, Oculus) in eyes with primary open-angle glaucoma (POAG) and normal control eyes. Methods: A comparative cross-sectional study that included 42 patients with POAG and 60 normal control subjects matched for intraocular pressure (IOP) and central corneal thickness (CCT). IOP was measured with a Goldmann applanation tonometer (GAT). Corneal tomography and biomechanical parameters were measured with Pentacam (Oculus) and CorVis ST, respectively. Corneal biomechanical properties were compared between groups, and the associations between corneal biomechanical parameters and ocular characteristics were evaluated. Receiver operating characteristic (ROC) curves were used to establish a cut-off value for the biomechanical parameters. Results: The following parameters of the CorVis ST showed a significant difference between eyes with POAG and normal eyes: first applanation velocity (V in ), second applanation time (A-time 2 ), peak distance (PD) and deformation amplitude (DA). In the univariate analysis, DA was negatively correlated with IOP in both groups. For all biomechanical parameters, the areas under the ROC curve were <0.80 and thus did not reach a good level of predictive accuracy for detecting POAG. Conclusion: CorVis ST offers an alternative method for measuring corneal biomechanical properties. Eyes with POAG exhibit a faster V in , longer A-time 2 , lower DA and longer PD than do IOP-and CCT-matched normal control eyes. The biomechanical parameters of the CorVis ST cannot readily be used for diagnosis of POAG in the individual patient.

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BackgroundThe measurement of dynamic parameters, such as the length of applanation and the amplitude of deformation, is significant for evaluating corneal properties. Most of the corneal properties (related to shape) including the anterior corneal curvature and the thickness of cornea can be easily measured using some existing techniques. However, they only provide the static or pseudo-dynamic analysis. Based on Corvis ST images, the dynamic features after corneal boundaries detection and parameter estimation will be helpful for corneal analysis.MaterialThe study included 40 eyes in normal group (ranging from 19 to 45 years old) and 30 eyes in keratoconus group (ranging from 16 to 40 years old). These eyes were examined by Corvis ST and for each one a sequence of 140 images was obtained. Besides, 11 subjects of each group were also tested by Pentacam.MethodsBy analyzing the video from the Corvis ST imaging, the fully dynamic curvature topography is proposed to evaluate the response of the anterior corneal surface to the air puff. The new method not only quantitatively measures the intact variation of anterior corneal surface but also provides an intuitive way to observe the dynamic change of the anterior corneal surface in the whole air stream process. The proposed method consists of three main steps: cornea segmentation, curvature estimation and integrated visualization. An automatic segmentation method based on the combination of prior knowledge with phase symmetry and asymmetry theory is firstly presented to detect the corneal boundaries. The Landau-new method is then used to estimate the anterior corneal surface. The corneal dynamic topography is finally obtained by combining the dynamic parameters with the original Corvis ST video, which is an improvement of the fusion technique proposed by Li et al.Results and conclusionBy comparing the segmentation results with manual method and built-in method of Corvis ST, the accuracy and robustness of our proposed segmentation method is demonstrated. The correctness of the estimated corneal anterior curvatures is also evaluated by comparing it with that of Pentacam which is considered to be able to provide the first-class measurement currently. The dynamic topography may be used to distinguish the dynamic behavior of normal corneas from that of keratoconus.Electronic supplementary materialThe online version of this article (doi:10.1186/s12938-015-0036-2) contains supplementary material, which is available to authorized users.

Silk proteins represent a unique choice in the selection of biomaterials that can be used for corneal tissue engineering and regenerative medical applications. We implanted helicoidal multilamellar arginine-glycine-aspartic acid-functionalized silk biomaterials into the corneal stroma of rabbits, and evaluated its biocompatibility. The corneal tissue was examined after routine hematoxylin-eosin staining, immunofluorescence for collagen I and III, and fibronectin, and scanning electron microscopy. The silk films maintained their integrity and transparency over the 180-day experimental period without causing immunogenic and neovascular responses or degradation of the rabbit corneal stroma. Collagen I increased, whereas Collagen III and fibronectin initially increased and then gradually decreased. The extracellular matrix deposited on the surface of the silk films, tightly adhered to the biomaterial. We have shown this kind of silk film graft has suitable biocompatibility with the corneal stroma and is an initial step for clinical trials to evaluate this material as a transplant biomaterial for keratoplasty tissue constructs.

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