M A Lago1, M J Rupérez2, C Monserrat1, F Martínez-Martínez3, S Martínez-Sanchis1, E Larra4, M A Díez-Ajenjo5, C Peris-Martínez6. 1. Departamento de Sistemas Informáticos y Computación, Universitat Politècnica de València, Camino de Vera s/n, 46022 València, Spain. 2. Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I, Av. de Vicent Sos Baynat, s/n, 12071 Castelló de la Plana, Spain. Electronic address: ruperez@uji.es. 3. Center for Machine Perception, Departament of Cybernetics, Czech Technical University in Prague, Karlovo namesti 13, Prague, Czech Republic. 4. AJL Ophtalmics, Ferdinand Zeppelin Kalea, Vitoria-Gasteiz 01510, Miñano, Araba, Spain. 5. Clínica Optométrica Fundació Lluís Alcanyís, Universitat de València, C/ Guardia Civil, 22 Cantonera amb C/ Vicente Barrera, 46020 València, Spain. 6. Fisabio Oftalmológica Médica, Bifurcación Pío Baroja-general Aviles, S/N, 46015 València, Spain.
Abstract
PURPOSE: The purpose of this study was the simulation of the implantation of intrastromal corneal-ring segments for patients with keratoconus. The aim of the study was the prediction of the corneal curvature recovery after this intervention. METHODS: Seven patients with keratoconus diagnosed and treated by implantation of intrastromal corneal-ring segments were enrolled in the study. The 3D geometry of the cornea of each patient was obtained from its specific topography and a hyperelastic model was assumed to characterize its mechanical behavior. To simulate the intervention, the intrastromal corneal-ring segments were modeled and placed at the same location at which they were placed in the surgery. The finite element method was then used to obtain a simulation of the deformation of the cornea after the ring segment insertion. Finally, the predicted curvature was compared with the real curvature after the intervention. RESULTS: The simulation of the ring segment insertion was validated comparing the curvature change with the data after the surgery. Results showed a flattening of the cornea which was in consonance with the real improvement of the corneal curvature. The mean difference obtained was of 0.74 mm using properties of healthy corneas. CONCLUSIONS: For the first time, a patient-specific model of the cornea has been used to predict the outcomes of the surgery after the intrastromal corneal-ring segments implantation in real patients.
PURPOSE: The purpose of this study was the simulation of the implantation of intrastromal corneal-ring segments for patients with keratoconus. The aim of the study was the prediction of the corneal curvature recovery after this intervention. METHODS: Seven patients with keratoconus diagnosed and treated by implantation of intrastromal corneal-ring segments were enrolled in the study. The 3D geometry of the cornea of each patient was obtained from its specific topography and a hyperelastic model was assumed to characterize its mechanical behavior. To simulate the intervention, the intrastromal corneal-ring segments were modeled and placed at the same location at which they were placed in the surgery. The finite element method was then used to obtain a simulation of the deformation of the cornea after the ring segment insertion. Finally, the predicted curvature was compared with the real curvature after the intervention. RESULTS: The simulation of the ring segment insertion was validated comparing the curvature change with the data after the surgery. Results showed a flattening of the cornea which was in consonance with the real improvement of the corneal curvature. The mean difference obtained was of 0.74 mm using properties of healthy corneas. CONCLUSIONS: For the first time, a patient-specific model of the cornea has been used to predict the outcomes of the surgery after the intrastromal corneal-ring segments implantation in real patients.
Authors: Francisco Cavas-Martínez; Daniel G Fernández-Pacheco; Dolores Parras; Francisco J F Cañavate; Laurent Bataille; Jorge Alió Journal: Biomed Eng Online Date: 2018-11-20 Impact factor: 2.819
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