Ocular Biomechanics - A Bright Future.
Ocular Biomechanics - A Bright Future.
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眼部生物力学 - 光明的未来。
DOI：
10.1080/02713683.2022.2154807
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发表时间：
2023
影响因子：
2
通讯作者：
Elsheikh A
中科院分区：
文献类型：
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作者：
Elsheikh A
在ARVO 2002年的一次令人难忘的主题演讲中，有人说，与我们对其他器官生物力学的理解相比，眼睛生物力学仍然处于“黑暗时代”。这次讲座是在辛西娅·罗伯茨发表了一篇题为“角膜不是一块塑料”的开创性文章几年后，她试图解释组织的复杂细胞和生物组成以及量化其生物力学特性的必要性。1自那时以来，该领域取得了令人难以置信的进展。这个特别的问题具有一系列的国家的最先进的审查领导人在眼生物力学领域。本文综述了角膜、巩膜、透镜、玻璃体和视网膜的最新生物力学研究，并对未来的研究方向提出了重要的观点。在这场长达20年的马拉松中，最初几年的重点是角膜生物力学，随着测试方法和结果可靠性的逐步改善，最初的重点是离体角膜分析。一开始，试纸测试很常见。解剖角膜和巩膜，切下组织条并进行单轴拉伸。不用说，该方法涉及几个缺点，包括损坏试样边缘，压平组织是自然弯曲的，使用的负载并不代表自然条件等，但是，简单的分析方法和广泛的可用性材料测试设备在研究实验室继续证明使用这种测试方法。尽管如此，它的结果被认为是足够的，但只是为了进行比较研究，当然不是为了获得组织的实际应力-应变行为。然后进行膨胀测试，其中将角膜或巩膜与眼球分离并经受模拟眼内压（IOP）的内部压力。这无疑是一个进步，虽然夹具定位沿着标本边缘并不真正代表现实生活中的条件。此外，分析最初基于壳理论，该理论错误地假设组织为球形且厚度均匀。随着时间的推移，这种分析方法被逆向建模所取代，从而可以更可靠地确定行为。不久之后，随着测试整个眼球，进一步的改进到来，允许更好地表示边界条件，并将角膜的行为与巩膜的行为联系起来。这一发展虽然具有显著的技术优势，但也使结果的测试和分析更具挑战性，并且仅限于全球少数研究实验室。
In a memorable keynote lecture at ARVO 2002, it was remarked that ocular biomechanics remained in “the dark ages” when compared to our understanding of biomechanics of other organs. This lecture came a couple of years after a seminal publication by Cynthia Roberts titled “The cornea is not a piece of plastic,” in which she attempted to explain the complex cellular and bio-composition of the tissue and the necessity of quantifying its biomechanic properties for several clinical applications. 1 Since then, the field has progressed beyond recognition. This special issue features a series of state-of-the-art reviews by leaders in the ocular biomechanics field. The reviews span the latest biomechanics research in cornea, sclera, lens, vitreous and retina and all offer important perspective on future directions. With a specific focus on corneal biomechanics, the first few years in this 20-year marathon saw initial emphasis on ex-vivo corneal analysis with gradual improvement in test methods and results’ reliability. At the beginning, strip testing was common. The cornea and sclera were dissected, and strips of tissue were cut out and subjected to uniaxial tension. Needless to say, the method involved several drawbacks including damage to the specimen edges, flattening a tissue that is naturally curved, using load that did not represent natural conditions, etc. However, the simple analysis method and the wide availability of material testing equipment in research labs continued to justify using this test method. Nevertheless, its results were considered adequate, but only for comparative studies, and certainly not for obtaining the actual stress-strain behaviour of the tissue. Inflation testing then followed in which the cornea or the sclera were separated from ocular globes and subjected to internal pressure simulating the intraocular pressure (IOP). This was certainly a step forward although the clamps positioned along specimen edge did not truly represent real-life conditions. Furthermore, the analysis was initially based on shell theory, which wrongly assumed the tissue to be spherical and with uniform thickness. Over time, this analysis method was replaced with inverse modelling allowing more reliable behaviour determination. And further improvements arrived soon afterwards with testing whole eye globes allowing much better representation of boundary conditions and relating the behaviour of the cornea to that of the sclera. This development, while carrying significant technical advantages, made the testing and analysis of results much more challenging, and confined to a small number of research labs worldwide.