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Consideration of corneal biomechanics in the diagnosis and management of keratoconus: is it important?

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Eye and Vision 2016年第1期3卷 141-146页

作者： fangjun bao Brendan Geraghty QinMei Wang Ahmed Elsheikh The Affiliated Eye Hospital of Wenzhou Medical University Wenzhou City 325027China The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhou City 325027China School of Engineering University of LiverpoolLiverpool City L693GHUK NIHR Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondon CityUK

Keratoconus is a bilateral,non-inflammatory,degenerative corneal *** occurrence and development of keratoconus is associated with corneal thinning and conical protrusion,which causes irregular *** the disruption of the collagen organization,the cornea loses its shape and function resulting in progressive visual ***,corneal topography is the most important tool for the diagnosis of keratoconus,which may lead to false negatives among the patient population in the subclinical ***,it is now hypothesised that biomechanical destabilisation of the cornea may take place ahead of the topographic evidence of keratoconus,hence possibly assisting with disease diagnosis and *** article provides a review of the definition,diagnosis,and management strategies for keratoconus based on corneal biomechanics.

关键词： Keratoconus In vivo Corneal biomechanics Corneal collagen cross-linking

Effect of orthokeratology on precision and agreement assessment of a new sweptsource optical coherence tomography biometer

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Eye and Vision 2020年第1期7卷 119-127页

作者： bao Shu fangjun bao Giacomo Savini Weicong Lu Ruixue Tu Haisi Chen Benhao Song Qinmei Wang Jinhai Huang School of Ophthalmology and Optometry and Eye Hospital Wenzhou Medical University270 West Xueyuan RoadWenzhou 325027ZhejiangChina Key Laboratory of Vision Science Ministry of HealthWenzhouZhejiangPeople’s Republic of China G.B.Bietti Foundation IRCCS RomeItaly

Background:To evaluate the effect of orthokeratology on precision of measurements in children using a new swept-source optical coherence tomography(SS-OCT)optical biometer(OA-2000),and agreement between its measurements and those provided by the commonly used IOLMaster based on partial coherence interferometry(PCI).Methods:This study recruited fifty-one eyes of 51 normal children(8–16 years).An operator took measurements with the two ***,a second operator took measurements with the SS-OCT *** orthokeratology was performed for one month,the same operators repeated the same *** length(AL),mean keratometry(Km)at 2.5 mm and 3.0 mm diameters(Km2.5 and Km3.0),central corneal thickness(CCT),anterior chamber depth(ACD),lens thickness(LT)and corneal diameter(CD)were ***:With the SS-OCT optical biometer,the test-retest repeatability of AL measurements was*** 95%limits of agreement of difference between the two devices for CD parameter were up to 1.53 *** orthokeratology,the fluctuation ranges of difference for Km3.0 measurement was 1.11 times higher than before orthokeratology,while the absolute values of difference for AL,Km2.5,ACD and CD measurements were ***:Before and after orthokeratology,the SS-OCT biometer showed high repeatability and reproducibility for all *** orthokeratology contact lenses affected the agreement between SS-OCT and PCI biometers for Km3.0 *** CD measurement showed poor agreement between the two devices.

关键词： Swept source optical coherence tomography Orthokeratology Precision Agreement Children

High intercorneal symmetry in corneal biomechanical metrics

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Eye and Vision 2016年第1期3卷 58-65页

作者： XiaoBo Zheng fangjun bao Brendan Geraghty JinHai Huang AYong Yu QinMei Wang The Affiliated Eye Hospital of Wenzhou Medical University WenzhouZhejiang Province 325027China The Institution of Ocular Biomechanics Eye HospitalWenzhou Medical UniversityNo.270#Xueyuan West RoadWenzhou CityZhejiang Province 325027China School of Engineering University of LiverpoolLiverpool L693GHUK

Backgroud:To evaluate the symmetry of corneal biomechanical metrics,measured using an ocular response analyzer(ORA)and self-built corneal inflation test platform,in bilateral rabbit corneas and to investigate their relationship with physical intraocular pressure(IOPp).Methods:Twenty fresh enucleated eyes from ten rabbits were used for ex vivo whole ocular globe *** was increased from 7.5 to 37.5 mmHg with 7.5 mmHg steps and biomechanical metrics were acquired using the *** least 3 examinations were performed at each pressure *** biomechanical metrics,corneal hysteresis(CH)and corneal resistance factor(CRF)were recorded and analyzed as a function of *** specimens were then excised from the intact ocular globe and tested under inflation conditions up to 45.7 mmHg posterior *** experimental pressure-deformation data was analyzed using an inverse modeling procedure to derive the stress-strain behavior of the ***:A comparison of corneal shape parameters showed no statistically significant difference(P>0.05)between bilateral ***,there were no statistically significant differences in values of CH,CRF and corneal stiffness(as measured by the tangent modulus,Et)between bilateral eyes(CH:F=0.94,P=0.54;CRF:F=4.42,P=0.35;Et:F=3.15,P=0.12)at different pressure *** was highly correlated with CRF while the relationship with CH was less ***:An obvious interocular symmetry in biomechanical metrics is found in this *** has been shown to have important influences on the value of CRF provided by ORA.

关键词： Intercorneal symmetry Corneal biomechanical metrics Corneal stiffness Ocular response analyzer

Ex vivo testing of intact eye globes under inflation conditions to determine regional variation of mechanical stiffness

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Eye and Vision 2016年第1期3卷 166-177页

作者： Charles Whitford Akram Joda Steve Jones fangjun bao Paolo Rama Ahmed Elsheikh School of Engineering University of LiverpoolLiverpool L693GHUK Department of Mechanical Engineering King Faisal UniversityHofufSaudi Arabia Eye Hospital WenZhou Medical UniversityWenZhouChina Ophthalmology Department San Raffaelle HospitalMilanItaly National Institute for Health Research(NIHR)Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology LondonUK

Background:The eye globe exhibits significant regional variation of mechanical *** aim of this present study is to develop a new experimental technique for testing intact eye globes in a form that is representative of in vivo conditions,and therefore suitable for determining the material properties of the complete outer ocular ***:A test rig has been developed to provide closed-loop control of either applied intra-ocular pressure or resulting apical displacement;measurement of displacements across the external surface of the eye globe using high-resolution digital cameras and digital image correlation software;prevention of rigid-body motion and protection of the ocular surface from environmental *** method has been demonstrated on one human and one porcine eye globe,which were cyclically *** element models based on specimen specific tomography,free from rotational symmetry,were used along with experimental pressure-displacement data in an inverse analysis process to derive the mechanical properties of tissue in different regions of the eye’s outer ***:The test method enabled monitoring of mechanical response to intraocular pressure variation across the surface of the eye *** the two eyes tested,the method showed a gradual change in the sclera’s stiffness from a maximum at the limbus to a minimum at the posterior pole,while in the cornea the stiffness was highest at the centre and lowest in the peripheral ***,for both the sclera and cornea,the load–displacement behaviour did not vary significantly between loading ***:The first methodology capable of mechanically testing intact eye globes,with applied loads and boundary conditions that closely represent in vivo conditions is *** method enables determination of the regional variation in mechanical behaviour across the ocular surface.

关键词： Ocular biomechanics Experimental testing Digital image correlation

Unintended changes in ocular biometric parameters during a 6-month follow-up period after FS-LASIK and SMILE

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Eye and Vision 2021年第1期8卷 75-82页

作者： Junjie Wang Bernardo T.Lopes Hechen Li Riccardo Vinciguerra Si Cao Songan Wu Rong Zhu Qinmei Wang Xiaobo Zheng fangjun bao Ahmed Elsheikh Eye Hospital Wenzhou Medical UniversityWenzhou 325027ZhejiangChina The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhou 325027ZhejiangChina School of Engineering University of LiverpoolLiverpool L693GHUK Humanitas San Pio X Hospital MilanItaly National Institute for Health Research(NIHR)Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK Beijing Advanced Innovation Center for Biomedical Engineering Beihang UniversityBeijingChina

Background:Corneal refractive surgery has become reliable for correcting refractive errors,but it can induce unintended ocular changes that alter refractive *** study is to evaluate the unintended changes in ocular biometric parameters over a 6-month follow-up period after femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE).Methods:156 consecutive myopic patients scheduled for FS-LASIK and SMILE were included in this *** corneal thickness(CCT),mean curvature of the corneal posterior surface(K_(pm)),internal anterior chamber depth(IACD)and the length from corneal endothelium to retina(ER)were evaluated before and after surgery over a 6-month ***:Both the FS-LASIK and SMILE groups(closely matched at the pre-surgery stage)experienced flatter Kpm,shallower IACD and decreased ER 1 week post-surgery(P<0.01),and these changes were larger in FS-LASIK than in SMILE *** the 1 week to 6 months follow up period,K_(pm),IACD and ER remained stable unlike CCT which increased significantly(P<0.05),more in the FS-LASIK ***:During the follow up,the posterior corneal surface became flatter and shifted posteriorly,the anterior chamber depth and the length from the corneal endothelium to retina decreased significantly compared with the pre-surgery *** unintended changes in ocular biometric parameters were greater in patients undergoing FS-LASIK than *** changes present clear challenges for IOL power calculations and should be considered to avoid affecting the outcome of cataract surgery.

关键词： Posterior corneal surface Internal anterior chamber depth The length from corneal endothelium to retina FS-LASIK SMILE

Review of in-vivo characterisation of corneal biomechanics

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Medicine in Novel Technology and Devices 2021年第3期11卷 34-39页

作者： Bernardo T.Lopes fangjun bao JunJie Wang XiaoYu Liu LiZhen Wang Ahmed Abass Ashkan Eliasy Ahmed Elsheikh School of Engineering University of LiverpoolLiverpoolUK Department of Ophthalmology Federal Univerisity of Sao Paulo(UNIFESP)Sao PauloBrazil Eye Hospital Wenzhou Medical UniversityWenzhouChina The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhouChina Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina Beijing Advanced Innovation Centre for Biomedical Engineering Beihang UniversityBeijingChina National Institute for Health Research(NIHR)Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK

The study of corneal biomechanics in vivo has been evolving fast in recent *** an organised corneal structure is necessary for its transparency,resistance to occasional external insults and bearing the intraocular pressure(IOP),which several clinically relevant events can *** review focuses on three techniques that are available for clinical use,namely the Ocular Response Analyzer(Reichert Ophthalmic Instruments,Buffalo,NY,USA),the Corvis ST(Oculus Optikgerate GmbH,Wetzlar,Germany)and the Brillouin Optical Scattering System(Intelon Optics Inc.,Lexington,MA,USA).The principles and the main parameters of each device are discussed along with their strategies to improve accuracy in the IOP measurement,corneal ectasia diagnosis,evaluation of corneal cross-linking procedures,and planning of corneal refractive surgeries.

关键词： Corneal biomechanics Corneal diagnosis Intraocular pressure Corneal ectasia Corneal cross linking

Review of ex-vivo characterisation of corneal biomechanics

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Medicine in Novel Technology and Devices 2021年第3期11卷 40-46页

作者： JunJie Wang XiaoYu Liu fangjun bao Bernardo T.Lopes LiZhen Wang Ashkan Eliasy Ahmed Abass Ahmed Elsheikh Eye Hospital Wenzhou Medical UniversityWenzhouChina The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhouChina Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina Beijing Advanced Innovation Centre for Biomedical Engineering Beihang UniversityBeijingChina School of Engineering University of LiverpoolLiverpoolUK Department of Ophthalmology Federal Univerisity of Sao Paulo(UNIFESP)Sao PauloBrazil National Institute for Health Research(NIHR)Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK

The evaluation of the corneal biomechanical behaviour has important clinical *** name a few,the accuracy of the intraocular pressure measurement,the study of corneal ectatic diseases and the assessment and optimisation of corneal surgical procedures are all highly influenced by corneal *** the last 45 years different ex-vivo methods were developed to study corneal biomechanical *** tissue maintenance,support,loading systems,as well as different monitoring strategies of corneal deformations were *** this review,the most important and commonly used methods are outlined,including strip extensiometry,inflation,compression,indentation and tissue separation *** particularities,applications,pros and cons and main applications are discussed.

关键词： Ex-vivo Corneal Biomechanics Experimental testing

Accuracy and reliability of orthogonal polynomials in representing corneal topography

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Medicine in Novel Technology and Devices 2022年第3期15卷 124-133页

作者： Junjie Wang Xuefei Li Zheng Wang Pinakin G.Davey Yiyu Li Lanting Yang Mao Lin Xiaobo Zheng fangjun bao Ahmed Elsheikh Eye Hospital Wenzhou Medical UniversityWenzhouChina The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhouChina College of Optometry Western University of Health SciencesPomonaCAUSA School of Engineering University of LiverpoolLiverpoolUK National Institute for Health Research(NIHR)Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK Beijing Advanced Innovation Center for Biomedical Engineering Beihang UniversityBeijingChina No.270 Xueyuan West Road Wenzhou CityZhejiang Province325027China

Fitting of corneal topography data to analytical surfaces has been necessary in many clinical and experimental applications,yet absolute superiority of fitting methods was still unclear,and their overfitting risks were not well *** study aimed to evaluate the accuracy and reliability of orthogonal polynomials as fitting routines to represent corneal *** orthogonal polynomials,namely,Zernike polynomials(ZPs),pseudo-Zernike polynomials(PZPs),Gaussian-Hermite polynomials(GHPs)and Orthogonal Fourier-Mellin polynomials(OFMPs),were employed to fit anterior and posterior corneal topographies collected from 200 healthy and 174 keratoconic eyes using Pentacam *** fitting performance of these polynomials were compared,and the potential overfitting risks were assessed through a prediction *** results showed that,except for low orders,the fitting performance differed little among polynomials with orders10 regarding surface reconstruction(RMSEs~0.3μm).Anterior surfaces of normal corneas were fitted more efficiently,followed by those of keratoconic corneas,then posterior corneal *** results,however,revealed an alarming fact that all polynomials tended to overfit the data beyond certain ***,closely followed by ZPs,were the most robust in predicting unmeasured surface locations;while PZPs and especially OFMPs overfitted the surfaces *** 10 appeared to be optimum for corneal surfaces with 10-mm diameter,ensuring accurate reconstruction and avoiding *** optimum order however varied with topography diameters and data *** study concluded that continuing to use ZPs as fitting routine for most topography maps,or using GHPs instead,remains a good *** polynomial orders close to the topography diameters(millimeters)is generally suggested to ensure both reconstruction accuracy and prediction reliability and avoid overfitting for both normal and complex(e.g.,keratoconic)corneal surfac

关键词： Corneal topography Orthogonal polynomials Optimum order Overfitting Pentacam

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角巩膜生物力学性能测量技术的研究进展

中华眼科杂志 2015年第11期51卷 875-880页

作者：包芳军邓曼丽王勤美温州医科大学附属眼视光医院 325027

近视眼及圆锥角膜的发生、发展与巩膜及角膜的生物力学性能改变密切相关.准确测量角巩膜生物力学性能在眼部疾病的诊断、眼科手术技术的改进、眼部生物参数的测量和眼科医疗器械的研发等方面具有非常重要的意义.角巩膜组织构成眼球外壁... 详细信息

近视眼及圆锥角膜的发生、发展与巩膜及角膜的生物力学性能改变密切相关.准确测量角巩膜生物力学性能在眼部疾病的诊断、眼科手术技术的改进、眼部生物参数的测量和眼科医疗器械的研发等方面具有非常重要的意义.角巩膜组织构成眼球外壁,主要由致密交错的胶原纤维束和细胞外基质组成.角巩膜内部各层及各区域间胶原纤维的直径、间隙和数量分布的差异,使其生物力学特征颇为复杂,表现为非线弹性、黏弹性、各向异性、区域差异性和年龄相关性等.随着医疗检查诊断技术的发展,临床逐渐认识到眼部生物力学性能的重要性,但由于多数眼科医师对眼部生物力学性能的测量技术仍不甚了解,故笔者就国际上角巩膜生物力学性能测量技术的发展进行综述,为临床选取合适的测量平台与方法测量和研究角巩膜生物力学性能提供帮助.

关键词：巩膜角膜生物力学诊断技术,眼科