Cleveland Clinic Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Cleveland Clinic Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; Dept. of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve Univ, Cleveland, OH, USA; Dept. of Biomedical Engineering, Lerner Research Institute and Case Western Reserve Univ, Cleveland, OH, USA.
Exp Eye Res. 2021 Apr;205:108508. doi: 10.1016/j.exer.2021.108508. Epub 2021 Feb 18.
The characterization of corneal biomechanical properties has important implications for the management of ocular disease and prediction of surgical responses. Corneal refractive surgery outcomes, progression or stabilization of ectatic disease, and intraocular pressure determination are just examples of the many key clinical problems that depend highly upon corneal biomechanical characteristics. However, to date there is no gold standard measurement technique. Since the advent of a 1-dimensional (1D) air-puff based technique for measuring the corneal surface response in 2005, advances in clinical imaging technology have yielded increasingly sophisticated approaches to characterizing the biomechanical properties of the cornea. Novel analyses of 1D responses are expanding the clinical utility of commercially-available air-puff-based instruments, and other imaging modalities-including optical coherence elastography (OCE), Brillouin microscopy and phase-decorrelation ocular coherence tomography (PhD-OCT)-offer new opportunities for probing local biomechanical behavior in 3-dimensional space and drawing new inferences about the relationships between corneal structure, mechanical behavior, and corneal refractive function. These advances are likely to drive greater clinical adoption of in vivo biomechanical analysis and to support more personalized medical and surgical decision-making.
角膜生物力学特性的特征对于眼部疾病的管理和手术反应的预测具有重要意义。角膜屈光手术的结果、扩张性疾病的进展或稳定,以及眼压的确定只是高度依赖于角膜生物力学特性的许多关键临床问题的几个例子。然而,到目前为止,还没有金标准的测量技术。自 2005 年出现用于测量角膜表面响应的一维(1D)空气脉冲技术以来,临床成像技术的进步已经产生了越来越复杂的方法来描述角膜的生物力学特性。对 1D 响应的新分析正在扩大商业上可用的空气脉冲仪器的临床应用,其他成像模式,包括光相干弹性成像(OCE)、布里渊显微镜和相位相关眼相干断层扫描(PhD-OCT),为在三维空间中探测局部生物力学行为提供了新的机会,并对角膜结构、力学行为和角膜屈光功能之间的关系得出新的推论。这些进展可能会推动更广泛地采用体内生物力学分析,并支持更个性化的医疗和手术决策。