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Simulation of corneal refractive surgery considering surgery-related biomechanical changes in the cornea

Poster Details

First Author: J.Wang UK

Co Author(s):    F. Bao   A. Elsheikh           

Abstract Details

Purpose:

To develop and evaluate a surgery planning tool based on a finite element (FE) model which simulates the laser in situ keratomileusis (LASIK) with accurate consideration of corneal biomechanical changes following the surgical procedures.

Setting:

The University of Liverpool, Liverpool, UK, and Wenzhou Medical University, Zhejiang, China.

Methods:

60 data sets of corneal topographies and ocular axial length were obtained before myopic LASIK correction and used to build patient-specific, whole-eye numerical models. The LASIK procedure was closely simulated involving stress-free configuration (deriving ocular state with no intraocular pressure (IOP)), creation of corneal flap, corneal ablation, adding wound healing effects and application of IOP. The predicted corneal elevation and refractive power were compared to the clinical postoperative measurements.

Results:

The LASIK model was able to produce postoperative outcome as measured clinically (obtained 1 month after surgery). The mean root mean square error between numerically predicted and clinically measured anterior surfaces in the central 3 mm diameter was 1.67 ± 0.60 μm. The predicted postoperative refractive power of the cornea (considering both anterior and posterior surfaces) was 36.84 ± 1.85 D, compared to the clinical mean 37.49 ± 1.90 D.

Conclusions:

The study developed a numerical method using FE models to simulate corneal biomechanical response to LASIK procedure. The accuracy and effectiveness of this numerical method are validated using a large clinical dataset and it is shown that considering corneal biomechanics is necessary for the accurate prediction and planning of refractive surgical outcome following LASIK. FINANCIAL DISCLOUSRE: NONE

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