Clinical and laboratory investigation of the biomechanical properties of the cornea
Clinical and laboratory investigation of the biomechanical properties of the cornea
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发表时间：
2012
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通讯作者：
Tariq A. Alhamad
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作者：
Tariq A. Alhamad
了解角膜的生物力学特性对于开发和改进新的可靠的标准程序非常重要，这些程序可以有效地用于评估任何疾病条件下的角膜行为，或者在任何眼科手术之前/之后。我们认为眼球反应分析仪(ORA)是唯一可以测量活体角膜生物力学特性的设备。然而，它在体内和体外都是第一次被使用。本论文对准分子激光原位角膜磨镶术和角膜交联术前后角膜的生物力学特性进行了临床和实验室研究，以加深我们对实验室和临床所需知识的理解。在这个项目中使用了不同的机器，包括ORA、Oculus Pentacam、分光光度计和UV-X照明系统。准分子激光原位角膜磨镶术(LASIK)是目前最著名的矫正屈光不正的手术之一，然而，一些先前的研究报道了角膜变薄引起的眼部问题。因此，我观察了手术对角膜中央/外周厚度和前后曲率的影响，并确定了它们对角膜生物力学特性的影响程度。在过去的十年里，许多研究都集中在改进和开发一种名为角膜胶原与核黄素和UVA交联术的新手术，该手术用于阻止角膜的角膜扩张(发生在圆锥角膜中，有时是屈光手术后)。在下一阶段，进行了一系列关于交联的实验，以确定这种手术对角膜的分子结构和生物力学性能的影响程度。这篇论文首次证明了在体外获得ORA信号是可能的，这为检查全眼和切除的角膜打开了可能性。这也被证实，CH值不仅代表角膜的生物力学特性，而且还取决于眼睛其余部分的存在。这些体外研究为未来的角膜生物力学研究开辟了许多可能性。
Understanding the biomechanical properties of the cornea is important in order to develop and improve new reliable standard procedures which can be used effectively to assess corneal behaviour in any disease condition, or before/after any ocular surgery. We believe that the Ocular Response Analyzer (ORA) is the only device that can measures the biomechanical properties of the cornea in vivo. However, it has been used for the first time both in vivo and in vitro. This thesis presents a clinical and laboratory investigation of the biomechanical properties of the cornea before/after LASIK and corneal cross-linking to improve our understanding of the knowledge required in both the laboratory and the clinic. Different machines were used in this project, including an ORA, an Oculus Pentacam, a spectrophotometer and a UV-X Illumination system. Laser in situ keratomileusis (LASIK) is, at present, one of the most well-known operations used to correct refractive errors; however, ocular problems arising from corneal thinning have been reported in some previous studies. Therefore, I looked at the effects of surgery on the central/peripheral thickness and the anterior/posterior curvature, and determined to what extent they affect the biomechanical properties of the cornea. During the past decade, much research has focused on improving and developing a new operation called corneal collagen cross-linking with riboflavin and UVA, which is used to stop the progression of keratectasia in the cornea (which occurs in keratoconus and sometimes follows refractive surgery). In the next phase, a range of experiments were conducted on cross-linking to determine to what extent this operation affects the molecular structure and biomechanical properties of the cornea. This thesis has shown for the first time that it is possible to obtain ORA signals in vitro and this opened up the possibility of examining whole eyes as well as excised corneas. It is also confirmed that the values of CH do not represent only a corneal biomechanical property, but rather depend on the presence of the rest of the eye. These in vitro studies have opened up a number of possibilities the future corneal biomechanical studies.