Numerical study on human cornea and modified multiparametric correction equation for Goldmann applanation tonometer.

Glaucoma, a chronic eye disease, is quoted to be a second leading cause of blindness with 66.8 million people suspected to be victimised by the same in year 2000 (Morrison, 2003), and is caused due to an elevated intraocular pressure (IOP). Goldmann Applanation tonometer (GAT), a gold standard (Organization, 2001), suffers from inefficacies to measure intra-ocular pressure (IOP) independent of the biomechanical properties of an eye. Thus, the purpose of this paper is to study the importance of wide range of corneal parameters and to propose a multiparametric correction equation for GAT based on a numerically simulated comprehensive finite element model (Dohadwala et al., 1998; Morrison, 2003; Organization, 2001). Towards this end, with the help of numerical model, the parameters considered in correction equation proposed elsewhere (Elsheikh et al., 2011) were extended to include combined influence of central corneal thickness (CCT), central anterior curvature (R), peripheral corneal thickness (PCT), corneal asphericity (Pa), age, measured IOP itself and, was separately studied for role played by corneal support orientation (θ°) in this aspect. Findings indicate that for a wide range of parameters considered, while increased age is related with gain in corneal stiffness, the maximum (average) individual effects of variations in PCT, Pa, CCT, age and θ° on IOPG were estimated at 0.25mmHg/100µ of PCT, 0.073mmHg/0.1 of Pa, 1.9mmHg/100µ of CCT, 24.3%/decade relative of IOPT and 0.95mmHg/5° increase in θ°. The multiparametric correction equation has been modified accordingly. The GAT correction equation can consider the combined effect of PCT, Pa, CCT, and age on IOPG. Separately the non-linear effect of θ° on IOPG cannot be ignored for reasons of precision.