Abstract
Optical properties of the cornea are responsible for correct vision; the ultrastructure allows optical transparency, and the biomechanical properties govern the shape, elasticity, or stiffness of the cornea, affecting ocular integrity and intraocular pressure. Therefore, the optical aberrations, corneal transparency, structure, and biomechanics play a fundamental role in the optical quality of human vision, ocular health, and refractive surgery outcomes. However, the inter-relationships of those properties are not yet reported at a macroscopic scale within the hierarchical structure of the cornea. This work explores the relationships between the biomechanics, structure, and optical properties (corneal aberrations and optical density) at a macro-structural level of the cornea through dual Placido–Scheimpflug imaging and air-puff tonometry systems in a healthy young adult population. Results showed correlation between optical transparency, corneal macrostructure, and biomechanics, whereas corneal aberrations and in particular spherical terms remained independent. A compensation mechanism for the spherical aberration is proposed through corneal shape and biomechanics.
Highlights
Corneal biomechanics is a branch of biomedical sciences that deals with the analysis of the stability of the tissue when an external load or pressure is applied [1,2] or when the intraocular pressure fluctuates
The biomechanical properties of the cornea are responsible for its shape and integrity, acting as a unique convergence point between balanced ductility to preserve aspherical geometry, stiffness to compensate the intraocular pressure, and an ultrastructure that allows optical transparency
The clinical relevance of the study of corneal biomechanics reached special interest with the development of refractive surgery techniques to modify the optical power of the cornea by laser ablation [13] or lenticular extraction [14]
Summary
Corneal biomechanics is a branch of biomedical sciences that deals with the analysis of the stability of the tissue when an external load or pressure is applied [1,2] or when the intraocular pressure fluctuates. The clinical relevance of the study of corneal biomechanics reached special interest with the development of refractive surgery techniques to modify the optical power of the cornea by laser ablation [13] or lenticular extraction [14]. Only confocal microscopes are currently clinically available, and they allow visualization of the cellular matrix, they are invisible for the stromal architecture [18] In this sense, Scheimpflug imaging provides excellent tomographic measurements of the macrostructure of the cornea as well as optical density (transparency) [19], which is widely reported in anterior segment analysis for the assessment of normal and keratoconus or ectatic corneas [20] or refractive surgery [21]. This work focuses on the inter-relationships of corneal biomechanics, optical, and structural properties to bring a comprehensive macroscale characterization of the cornea that can provide future predictive models of corneal biomechanics
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