Assessment of the epithelium's contribution to corneal biomechanics.

Determining the epithelium's contribution to corneal biomechanics is important for the predictive numerical simulation of corneal biomechanical behaviour in which the cornea's five main layers are represented separately. Twenty-four corneal buttons were tested under posterior inflation conditions while monitoring their behaviour using non-contact methods. The corneas were divided into two groups of 12; one with and one without the epithelium. Control of specimen hydration, temperature and pressure application rate, and limiting the programme to specimens within a small age range resulted in a narrow scatter of test results. On average, intact specimens were able to carry slightly more pressure at the same deformation, and experienced less average stress for the same strain, compared with specimens without the epithelium. These results indicated that the stiffness of the epithelium was considerably lower than that of the stroma, and might therefore be ignored in numerical simulation studies.