Patient-specific finite element analysis of human corneal lenticules: An experimental and numerical study

Nambiar, Malavika H.; Liechti, Layko; Studer, Harald; Roy, Abhijit S.; Seiler, Theo G.; Büchler, Philippe

doi:10.1016/j.jmbbm.2023.106141

Cited by 1 publication

(1 citation statement)

References 33 publications

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“…As already anticipated, this is a limitation for all the current studies on corneal biomechanics, given that PS material properties are still unknown, but research is advancing fast in this field. 4 , 42 , 43 , 51 , 54 Third, even if we accurately reproduced the ablation profile from patient's treatment plan in a central optical region of 6.5 mm, we did not have direct access to the specific point-wise pattern, given that laser ablation algorithm is proprietary of the manufacturing company.…”

Section: Discussionmentioning

confidence: 99%

Establishing Standardization Guidelines For Finite-Element Optomechanical Simulations of Refractive Laser Surgeries: An Application to Photorefractive Keratectomy

Fantaci,

Calvo,

Barraquer

et al. 2024

Trans. Vis. Sci. Tech.

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Purpose Computational models can help clinicians plan surgeries by accounting for factors such as mechanical imbalances or testing different surgical techniques beforehand. Different levels of modeling complexity are found in the literature, and it is still not clear what aspects should be included to obtain accurate results in finite-element (FE) corneal models. This work presents a methodology to narrow down minimal requirements of modeling features to report clinical data for a refractive intervention such as PRK. Methods A pipeline to create FE models of a refractive surgery is presented: It tests different geometries, boundary conditions, loading, and mesh size on the optomechanical simulation output. The mechanical model for the corneal tissue accounts for the collagen fiber distribution in human corneas. Both mechanical and optical outcome are analyzed for the different models. Finally, the methodology is applied to five patient-specific models to ensure accuracy. Results To simulate the postsurgical corneal optomechanics, our results suggest that the most precise outcome is obtained with patient-specific models with a 100 µm mesh size, sliding boundary condition at the limbus, and intraocular pressure enforced as a distributed load. Conclusions A methodology for laser surgery simulation has been developed that is able to reproduce the optical target of the laser intervention while also analyzing the mechanical outcome. Translational Relevance The lack of standardization in modeling refractive interventions leads to different simulation strategies, making difficult to compare them against other publications. This work establishes the standardization guidelines to be followed when performing optomechanical simulations of refractive interventions.

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