Yuhas Phillip T, Roberts Cynthia J
College of Optometry, The Ohio State University, Columbus, OH, USA.
Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.
Curr Eye Res. 2023 Feb;48(2):89-104. doi: 10.1080/02713683.2022.2125530. Epub 2022 Oct 14.
Ocular biomechanics is an assessment of the response of the structures of the eye to forces that may lead to disease development and progression, or influence the response to surgical intervention. The goals of this review are (1) to introduce basic biomechanical principles and terminology, (2) to provide perspective on the progress made in the clinical study and assessment of ocular biomechanics, and (3) to highlight critical studies conducted in keratoconus, laser refractive surgery, and glaucoma in order to aid interpretation of biomechanical parameters in the laboratory and in the clinic. A literature review was first conducted of basic biomechanical studies related to ocular tissue. The subsequent review of ocular biomechanical studies was limited to those focusing on keratoconus, laser refractive surgery, or glaucoma using the only two commercially available devices that allow rapid assessment of biomechanical response in the clinic. Foundational studies on ocular biomechanics used a combination of computer modeling and destructive forces on ex-vivo tissues. The knowledge gained from these studies could not be directly translated to clinical research and practice until the introduction of non-contact tonometers that quantified the deformation response of the cornea to an air puff, which represents a non-destructive, clinically appropriate load. The corneal response includes a contribution from the sclera which may limit corneal deformation. Two commercial devices are available, the Ocular Response Analyzer which produces viscoelastic parameters with a customized load for each eye, and the Corvis ST which produces elastic parameters with a consistent load for every eye. Neither device produces the classic biomechanical properties reported in basic studies, but rather biomechanical deformation response parameters which require careful interpretation. Research using clinical tools has enriched our understanding of how ocular disease alters ocular biomechanics, as well as how ocular biomechanics may influence the pathophysiology of ocular disease and response to surgical intervention.
眼部生物力学是对眼睛结构对可能导致疾病发生和发展的力或影响手术干预反应的力的反应进行评估。本综述的目的是：（1）介绍基本的生物力学原理和术语；（2）阐述眼部生物力学临床研究和评估所取得的进展；（3）重点介绍圆锥角膜、激光屈光手术和青光眼方面的关键研究，以帮助解读实验室和临床中的生物力学参数。首先对与眼组织相关的基础生物力学研究进行了文献综述。随后对眼部生物力学研究的回顾仅限于那些使用仅有的两种可在临床上快速评估生物力学反应的商用设备，聚焦于圆锥角膜、激光屈光手术或青光眼的研究。眼部生物力学的基础研究使用了计算机建模和对离体组织施加破坏力的组合方法。在引入能够量化角膜对气流脉冲的变形反应的非接触眼压计之前，从这些研究中获得的知识无法直接转化为临床研究和实践，这种气流脉冲代表一种非破坏性的、临床适用的负荷。角膜反应包括巩膜的贡献，这可能会限制角膜变形。有两种商用设备可供使用，即眼部反应分析仪，它为每只眼睛提供定制负荷下的粘弹性参数；还有Corvis ST，它为每只眼睛提供恒定负荷下的弹性参数。这两种设备都不会产生基础研究中报道的经典生物力学特性，而是产生需要仔细解读的生物力学变形反应参数。使用临床工具的研究丰富了我们对眼部疾病如何改变眼部生物力学，以及眼部生物力学如何影响眼部疾病病理生理学和手术干预反应的理解。
