School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.
Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China.
Biomed Eng Online. 2021 Nov 20;20(1):113. doi: 10.1186/s12938-021-00948-7.
The corneal biomechanical properties with the prolongation of time after corneal refractive surgery are important for providing a mechanical basis for the occurrence of clinical phenomena such as iatrogenic keratectasia and refractive regression. The aim of this study was to explore the changes of corneal elastic modulus, and stress relaxation properties from the 6-month follow-up observations of rabbits after a removal of anterior corneal tissue in simulation to corneal refractive surgery.
The anterior corneal tissue, 6 mm in diameter and 30-50% of the original corneal thickness, the left eye of the rabbit was removed, and the right eye was kept as the control. The rabbits were normally raised and nursed for 6 months, during which corneal morphology data, and both of corneal hysteresis (CH) and corneal resistance factor (CRF) were gathered. Uniaxial tensile tests of corneal strips were performed at months 1, 3, and 6 from 7 animals, and corneal collagen fibrils were observed at months 1, 3, and 6 from 1 rabbit, respectively.
Compared with the control group, there were statistical differences in the curvature radius at week 2 and month 3, and both CH and CRF at months 1, 2, and 6 in experiment group; there were statistical differences in elastic modulus at 1, 3, and month 6, and stress relaxation degree at month 3 in experiment group. The differences in corneal elastic modulus, stress relaxation degree and the total number of collagen fibrils between experiment and control groups varied gradually with time, and showed significant changes at the 3rd month after the treatment.
Corneas after a removal of anterior corneal tissue undergo dynamic changes in corneal morphology and biomechanical properties. The first 3 months after treatment could be a critical period. The variation of corneal biomechanical properties is worth considering in predicting corneal deformation after a removal of anterior corneal tissue.
角膜生物力学特性随时间延长在角膜屈光手术后发生变化,这对了解医源性角膜扩张和屈光回退等临床现象的发生具有重要的力学基础。本研究旨在通过模拟角膜屈光手术,去除兔眼角膜前部组织,观察 6 个月后角膜弹性模量和应力松弛特性的变化。
切除兔左眼 6mm 直径、角膜厚度 30%~50%的前部角膜组织,右眼作为对照。正常饲养和护理 6 个月,采集角膜形态学数据和角膜滞后值(CH)、角膜阻力因子(CRF)。从 7 只兔中分别于术后 1、3、6 个月取角膜条进行单轴拉伸试验,从 1 只兔中分别于术后 1、3、6 个月取角膜观察胶原纤维排列。
与对照组相比,实验组在第 2 周和第 3 个月时曲率半径有统计学差异,在第 1、2、6 个月时 CH 和 CRF 有统计学差异;实验组在第 1、3、6 个月时弹性模量有统计学差异,在第 3 个月时应力松弛度有统计学差异。实验组与对照组之间的角膜弹性模量、应力松弛度和胶原纤维总数的差异随时间逐渐变化,在治疗后第 3 个月时变化明显。
去除角膜前部组织后,角膜形态和生物力学特性发生动态变化。治疗后前 3 个月可能是一个关键时期。在预测去除角膜前部组织后的角膜变形时,应考虑角膜生物力学特性的变化。