Biomechanical and optical behavior of human corneas before and after photorefractive keratectomy

Purpose To evaluate numerically the biomechanical and optical behavior of human corneas and quantitatively estimate the changes in refractive power and stress caused by photorefractive keratectomy (PRK). Setting Athineum Refractive Center, Athens, Greece, and Politecnico di Milano, Milan, Italy. Design Retrospective comparative interventional cohort study. Methods Corneal topographies of 10 human eyes were taken with a scanning-slit corneal topographer (Orbscan II) before and after PRK. Ten patient-specific finite element models were created to estimate the strain and stress fields in the cornea in preoperative and postoperative configurations. The biomechanical response in postoperative eyes was computed by directly modeling the postoperative geometry from the topographer and by reproducing the corneal ablation planned for the PRK with a numerical reprofiling procedure. Results Postoperative corneas were more compliant than preoperative corneas. In the optical zone, corneal thinning decreased the mechanical stiffness, causing local resteepening and making the central refractive power more sensitive to variations in intraocular pressure (IOP). At physiologic IOP, the postoperative corneas had a mean 7% forward increase in apical displacement and a mean 20% increase in the stress components at the center of the anterior surface over the preoperative condition. Conclusion Patient-specific numerical models of the cornea can provide quantitative information on the changes in refractive power and in the stress field caused by refractive surgery. Financial Disclosures No author has a financial or proprietary interest in any material or method mentioned. © 2014 ASCRS and ESCRS

Corneal morphology after ex vivo UV and mid-infrared laser ablation

In this work, ablation experiments of ex vivo porcine cornea tissue were conducted with two solid state lasers ( an Er:YAG laser and the 4(th) harmonic of an Nd:YAG laser, both in the ns pulse width range) emitting in mid infrared and ultraviolet part of the spectrum respectively, at moderate laser fluences. The cornea epithelium of each porcine eye was manually removed before the ablation. Histology analysis of the specimens was performed, in order to examine the microscopic appearance of the ablated craters and the existence of any thermal or mechanical damage caused by the mid-infrared and the UV laser irradiation. For a detailed and complete examination of the morphology of the laser ablated corneal tissue, the surface roughness was investigated by scanning electron microscopy