Biomechanical behavior of deep anterior lamellar keratoplasty: a finite element analysis

Jianhan Chen, Yueshan Huang, Runfeng Li, Xi Wen and Yonghua Lao

Computer Methods in Biomechanics and Biomedical Engineering, 2024, vol. 27, issue 16, 2400-2409

Abstract: Deep Anterior Lamellar Keratoplasty (DALK) is a surgical procedure used to restore sight and manage corneal diseases by replacing cloudy corneal tissue with allogeneic normal corneal tissue or artificial corneal material. However, the limited availability and mechanical defects of artificial corneal materials pose challenges in DALK. To predicting postoperative mechanical behavior of Deep Anterior Lamellar Keratoplasty (DALK), a three-dimensional finite element model of the postoperative DALK cornea with suture holes was developed. The postoperative corneal displacement and von Mises (VM) stress changes were also simulated under varying depths of cut (DOC: 0.16-0.26 μm), intraocular pressure (IOP: 12, 15, 18 mmHg), and central corneal thickness (CCT: 420-620 μm). The model indicated that higher IOP and CCT were associated with improved postoperative corneal stability. The postoperative corneal displacement increased from the edge to the center, while the maximum VM stress value occurs at the corneal suture hole. Corneal displacement and VM stress decrease with increasing CCT and decreasing IOP. DOC has a slight effect on corneal displacement and VM stress, with an overall positive relationship. The model has potential application in the preoperative assessment of risk in keratoplasty.

Date: 2024
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DOI: 10.1080/10255842.2023.2290459

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