97227 20210902121844.0 doi 10.1167/tvst.9.11.26 sideral 120924 ART-2020-120924 eng Ariza-Gracia, M.A. Corneal Biomechanics After Intrastromal Ring Surgery: Optomechanical In Silico Assessment 2020 Access copy available to the general public Unrestricted Purpose: To provide a biomechanical framework to better understand the postsurgical optomechanical behavior of the cornea after ring implantation. Methods: Calibrated in silico models were used to determine the corneal shape and stresses after ring implantation. After mechanical simulations, geometric ray-tracing was used to determine the change in spherical equivalent. The effect of the surgical procedure, circadian variation of intraocular pressure, or the biomechanical weakening introduced by keratoconus (KC) were evaluated for each intrastromal ring. Results: Models predicted the postsurgical optomechanical response of the cornea at a population level. The localized mechanical effect of the additional intrastromal volume introduced by the implants (size and diameter) drives the postsurgical corneal response. However, central corneal stresses did not increase more than 50%, and thus implants did not strengthen the cornea globally. Because of the biomechanical weakening introduced by laser pocketing, continuous implants in a pocket resulted in higher refractive corrections and in the relaxation of the anterior stroma, which could slow down KC progression. Implants can move within the stroma, acting as a dynamic pivot point that modifies corneal kinematics and flattens the corneal center. Changes in stromal mechanical properties did not impact on refraction for normal or pathological corneas. Conclusions: Implants do not stiffen the cornea but create a local bulkening effect that regularizes the corneal shape by modifying corneal kinematics without canceling corneal motion. Translational Relevance: In silico models can help to understand corneal biomechanics, to plan patient-specific interventions, or to create biomechanically driven nomograms. info:eu-repo/grantAgreement/ES/DGA-FSE/T24-20R info:eu-repo/grantAgreement/EC/H2020/786692/EU/Multiscale Integrative Approach for Corneal Biomechanics to Assess Corneal Crosslinking/MIMetiCO This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No H2020 786692-MIMetiCO info:eu-repo/grantAgreement/ES/MINECO/BES-2015-073630 info:eu-repo/grantAgreement/ES/MINECO/DPI2017-84047-R info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 3.283 2020 OPHTHALMOLOGY 19 / 62 = 0.306 2020 Q2 T1 1.508 2020 Ophthalmology 2020 Q1 Biomedical Engineering 2020 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Flecha-Lescun, J. Universidad de Zaragoza Buchler, P. Calvo, B. Universidad de Zaragoza (orcid)0000-0001-9713-1813 5004 605 Universidad de Zaragoza Dpto. Ingeniería Mecánica Área Mec.Med.Cont. y Teor.Est. 9, 11 (2020), 26 [16 pp] Transl. vis. sci. technol. Translational vision science & technology 2164-2591 1256297 http://zaguan.unizar.es/record/97227/files/texto_completo.pdf Versión publicada 46508 http://zaguan.unizar.es/record/97227/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:97227 articulos driver 2021-09-02-10:25:30 ARTICLE