Perfecting Laser Treatment for Regular and Irregular Astigmatism

Alpins, Noel; Stamatelatos, George

doi:10.17925/usor.2022.16.2.50

Cited by 1 publication

(1 citation statement)

References 12 publications

(19 reference statements)

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“…In particular, FE models can be useful for investigating aspects that cannot be assessed in daily clinical practice, such as mechanical changes that will lead to unforeseen postsurgical optical changes, or to help plan surgeries in which the mechanical dependence is so strong that they still remain an open clinical problem, such as astigmatism correction. 50 Unfortunately, reproducibility remains an issue unless all the modeling details are disclosed.…”

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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Section: Discussionmentioning

confidence: 99%