Key Laboratory of Nondestructive Test (Ministry of Education), Nanchang Hangkong University, Nanchang, China.
Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital; Nankai University Eye Institute, Nankai University; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.
Transl Vis Sci Technol. 2023 Apr 3;12(4):5. doi: 10.1167/tvst.12.4.5.
This study analyzed the biomechanical responses of different corneal cap thicknesses after small incision lenticule extraction (SMILE).
Individual finite element models of myopic eyes were constructed based on the clinical data. Then, four types of corneal cap thicknesses after SMILE were included for each model. The biomechanical effects of material parameters and intraocular pressure on corneas with different cap thicknesses were analyzed.
When the cap thickness increased, the vertex displacements of the anterior and posterior corneal surfaces decreased slightly. The corneal stress distributions demonstrated little change. Regarding wave-front aberrations caused by the displacements of the anterior surface, the absolute defocus value decreased slightly, but the magnitude of primary spherical aberration increased slightly. The horizontal coma increased, and the levels of other low-order and high-order aberrations were small and demonstrated little change. The corneal vertex displacement and wave-front aberration were significantly affected by elastic modulus and intraocular pressure, whereas the corneal stress distribution was greatly affected by intraocular pressure. There were obvious individual differences in the biomechanical responses of human eyes.
The biomechanical difference of different corneal cap thicknesses after SMILE was small. The effect of corneal cap thickness was significantly less than that resulting from material parameters and intraocular pressure.
Individual models were constructed based on the clinical data. The elastic modulus was controlled by programming to simulate its heterogeneous distribution in the actual human eye. The simulation was improved to bridge the gap between basic research and clinical care.
本研究分析了不同角膜帽厚度对小切口角膜透镜取出术（SMILE）后生物力学反应的影响。
基于临床数据，构建了近视眼的个体有限元模型。然后，为每个模型纳入了 4 种 SMILE 后的角膜帽厚度。分析了不同帽厚度下材料参数和眼内压对角膜的生物力学影响。
随着帽厚度的增加，前、后角膜表面顶点位移略有减小。角膜的应力分布变化不大。对于前表面位移引起的波前像差，绝对离焦值略有减小，但初级球差的幅度略有增加。水平彗差增加，其他低阶和高阶像差的水平较小且变化不大。角膜顶点位移和波前像差受弹性模量和眼内压的显著影响，而角膜的应力分布受眼内压的影响较大。人眼的生物力学反应存在明显的个体差异。
SMILE 后不同角膜帽厚度的生物力学差异较小。角膜帽厚度的影响明显小于材料参数和眼内压的影响。
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