Abstract
Purpose. Topographic and tomographic parameters are often not sufficient for early diagnosis of corneal changes. Pathological processes begin in the microstructure before topographic/tomographic abnormalities become apparent. Biomechanical parameters correlate strongly with microscopic structural parameters, while they can be used for early detection of ectasia. Material and Methods. This review summarizes the biomechanical properties of the cornea with regard to the detection of early ectasia and keratoconus. Air-puff tonometry is used to record the deformation behavior of the cornea and to derive corneal deformation parameters and biomechanical indices for ectasia detection. Results. The biomechanical parameters in keratoconus differ significantly from those of healthy eyes. Changes in the cornea can be detected even before topographic or tomographic changes. Artificial intelligence approaches support the merging of the numerous available data on single parameters for appropriate handling in clinical practice. Conclusion. Examination of corneal biomechanics using air-puff tonometry is a new method to detect possible early changes in the tissue. The biomechanical parameters, especially those of Scheimpflug-based air-puff tonometry, reveal changes before they are visible on topography or tomography. This is of great importance in refractive surgery, but also in the management of keratoconus.
Published Version
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