In vivo evaluation of corneal biomechanics in clinical practice; why, when and how?

Abstract

AbstractThe study of corneal biomechanics in vivo has been evolving fast in recent years. While an organized corneal structure is necessary for its transparency, resistance to occasional external insults and bearing the intraocular pressure (IOP), which several clinically relevant events can disturb.While significant technological advances have been made for the detection of morphologic markers of keratoconus, these findings are of later sequalae of the disease. Keratoconus is thought to begin with a focal biomechanical weakening of the cornea, followed by a cycle of decompensation resulting in corneal thinning and increased curvature [39, 40]. With the increasing number of corneal refractive surgeries being performed, the identification of the earliest form of the disease, before any morphologic changes have occurred, has become of paramount importance. This has led to efforts directed at measuring the in vivo biomechanical properties of the cornea.I will speak about techniques currently available for clinical use.The principles will be discussed along with their strategies to improve accuracy in the IOP measurement, corneal ectasia diagnosis, evaluation of corneal cross‐linking procedures, and planning of corneal refractive surgeries.