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      Corneal Biomechanical Properties in Different Ocular Conditions and New Measurement Techniques

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          Abstract

          Several refractive and therapeutic treatments as well as several ocular or systemic diseases might induce changes in the mechanical resistance of the cornea. Furthermore, intraocular pressure measurement, one of the most used clinical tools, is also highly dependent on this characteristic. Corneal biomechanical properties can be measured now in the clinical setting with different instruments. In the present work, we review the potential role of the biomechanical properties of the cornea in different fields of ophthalmology and visual science in light of the definitions of the fundamental properties of matter and the results obtained from the different instruments available. The body of literature published so far provides an insight into how the corneal mechanical properties change in different sight-threatening ocular conditions and after different surgical procedures. The future in this field is very promising with several new technologies being applied to the analysis of the corneal biomechanical properties.

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          Determining in vivo biomechanical properties of the cornea with an ocular response analyzer.

          David Luce (2005)
          To study the results of an ocular response analyzer (ORA) to determine the biomechanical properties of the cornea and their relationship to intraocular pressure (IOP). Reichert Inc., Depew, New York, USA. The ORA (Reichert) makes 2 essentially instantaneous applanation measurements that permit determination of corneal and IOP effects. Measurements of several populations indicate that corneal hysteresis, a biomechanical measure, varied over a dynamic range of 1.8 to 14.6 mm Hg and was only weakly correlated with corneal thickness (r(2)=0.12); this is related to the observation that some subjects with relatively thick corneas have less-than-average corneal hysteresis. Corneal hysteresis changes diurnally, presumably as a result of hydration changes. Keratoconus, Fuchs' dystrophy, and post-LASIK patients demonstrated low corneal hysteresis. The corneal hysteresis biomechanical measure may prove valuable for qualification and predictions of outcomes of refractive surgery and in other cases in which corneal biomechanics are important.
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            Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet-A-induced cross-linking.

            Gregor Wollensak, Eberhard Spoerl, Theo Seiler (2003)
            To evaluate the biomechanical effect of combined riboflavin-ultraviolet A (UVA) treatment on porcine and human corneas. Department of Ophthalmology, Technical University of Dresden, Dresden, Germany. Corneal strips from 5 human enucleated eyes and 20 porcine cadaver corneas were treated with the photosensitizer riboflavin and irradiated with 2 double UVA diodes (370 nm, irradiance = 3 mW/cm2) for 30 minutes. After cross-linking, static stress-strain measurements of the treated and untreated corneas were performed using a microcomputer-controlled biomaterial tester with a prestress of 5 x 10(3) Pa. There was a significant increase in corneal rigidity after cross-linking, indicated by a rise in stress in treated porcine corneas (by 71.9%) and human corneas (by 328.9%) and in Young's modulus by the factor 1.8 in porcine corneas and 4.5 in human corneas. The mean central corneal thickness was 850 microm +/- 70 (SD) in porcine corneas and 550 +/- 40 microm in human corneas. Riboflavin-UVA-induced collagen cross-linking led to an increase in mechanical rigidity in porcine corneas and an even greater increase in human corneas. As collagen cross-linking is maximal in the anterior 300 microm of the cornea, the greater stiffening effect in human corneas can be explained by the relatively larger portion of the cornea being cross-linked in the overall thinner human cornea.
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              Changes in collagen orientation and distribution in keratoconus corneas.

              Dawn P Gill, Sally Hayes, Stephen J. Tuft … (2005)
              To map the collagen orientation and relative distribution of collagen fibrillar mass in keratoconus corneal buttons. Structural analysis was performed by obtaining synchrotron x-ray scattering patterns across the samples at 0.25-mm intervals. The patterns were analyzed to produce two-dimensional maps of the orientation of the lamellae and of the distribution of total and preferentially aligned lamellae. Compared with normal corneas, in keratoconus the gross organization of the stromal lamellae was dramatically changed, and the collagen fibrillar mass was unevenly distributed, particularly around the presumed apex of the cone. The development of keratoconus involves a high degree of inter- and probably intralamellar displacement and slippage that leads to thinning of the central cornea and associated changes in corneal curvature. This slippage may be promoted by a loss of cohesive forces and mechanical failure in regions where lamellae bifurcate.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ISRN Ophthalmol
                Journal ID (iso-abbrev): ISRN Ophthalmol
                Journal ID (publisher-id): ISRN.OPHTHALMOLOGY
                Title: ISRN Ophthalmology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-5688
                ISSN (Electronic): 2090-5696
                Publication date Collection: 2014
                Publication date (Electronic): 4 March 2014
                Volume: 2014
                Electronic Location Identifier: 724546
                Affiliations
                1Clinical & Experimental Optometry Research Lab, Center of Physics (Optometry), School of Sciences, University of Minho, Gualtar, 4710-057 Braga, Portugal
                2Grupo de Investigación en Superficie Ocular y Lentes de Contacto, Departamento de Cirugía (Oftalmología), Universidad de Santiago de Compostela, 15782 A Coruña, Spain
                3Department of Ophthalmology, Centro Hospital de Entre Douro e Vouga, Santa Maria da Feira, Portugal
                4Department of Ophthalmology, Hospital Escola, Universidade Fernando Pessoa, Gondomar, Portugal
                Author notes
                *Jose Manuel González-Méijome: jgmeijome@ 123456fisica.uminho.pt

                Academic Editors: M. Baskaran and A. Daxer

                Author information
                http://orcid.org/0000-0002-3921-6357
                http://orcid.org/0000-0003-1045-4455
                Article
                DOI: 10.1155/2014/724546
                PMC ID: 3960740
                PubMed ID: 24729900
                SO-VID: cfcc344b-104d-488b-940a-e88773cbf7ed
                Copyright © Copyright © 2014 Nery Garcia-Porta et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 October 2013
                Date accepted : 26 November 2013
                Categories
                Subject: Review Article

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