Cornea biomechanical analysis with Brillouin microscopy

项目总结： 圆锥角膜和相关的角膜扩张症是年轻人视力丧失的主要原因，主要问题是 在屈光手术治疗近视的过程中，筛查和角膜移植的主要适应症 我们。已知这些情况是由角膜之间机械平衡的破坏引起的。 力量和眼内向外压，可自然发生在扩张性疾病中，或可由 屈光手术程序。虽然在最早的时候识别受损的(扩张的)角膜是至关重要的 目前的成像技术无法做到这一点，因为它们只能评估角膜的形态(形状)和 而不是角膜生物力学。这使得医生和患者在诊断时获得的信息有限 圆锥角膜，或在计划手术时。为了克服目前角膜筛查的局限性，我们有 开发了一种名为布里渊显微镜的光学技术，它可以在3英寸高的温度下测量角膜硬度。 立体分辨率，不接触或干扰眼睛。这项研究计划的总体目标是 改进角膜扩张性疾病的诊断和管理，提高手术的安全性和预后 通过引入新的角膜生物力学轮廓进行屈光外科手术。我们的中央 假说是，角膜机械性能的空间局部性变化是导致 临床上观察到的形态行为。这一假设是由强劲的初步数据推动的，初步数据显示 活体角膜扩张性显著的区域依赖性改变。拟议的研究将继续进行 三个具体目标：1)验证用于角膜机械评估的布里渊测量；2) 亚临床圆锥角膜局灶性布里渊模数变化特征；3)确定机械冲击 角膜上的屈光手术和交联术。这项研究意义重大，因为 基于弹性的指标将使早期识别角膜扩张症患者在治疗时 对有可能发展为术后扩张症的个体进行最大限度的、适当的筛查 否则接受准分子激光原位角膜磨镶术，并客观评估与屈光有关的机械退化 程序。最终，从这项研究中获得的知识可能会导致 个性化屈光手术和基于患者潜在疾病的交叉治疗方案 生物力学状态。

PROJECT SUMMARY: Keratoconus and related corneal ectasias are a major cause of vision loss in young adults, the primary concern during refractive surgery screening to treat myopia, and the leading indication for corneal transplantation in the US. These conditions are known to be triggered by the disruption of the mechanical balance between corneal strength and intraocular outward pressure, which can occur naturally in ectatic disorders or can be triggered by refractive surgery procedures. While it is critical to identify weakened (ectatic) corneas at their earliest time point, current imaging techniques are unable to do that, as they only assess corneal morphology (shape) and not corneal biomechanics. This leaves doctors and patients with limited information when diagnosing keratoconus, or when planning surgeries. To overcome current corneal screening limitations, we have developed an optical technology, Brillouin microscopy, which can measure corneal stiffness at high 3- dimensional resolution without contacting or perturbing the eye. The overall goal of this research program is to improve diagnosis and management of corneal ectatic disorders and to improve the safety and outcome of refractive surgery procedures by introducing novel biomechanical profiling of the cornea. Our central hypothesis is that spatially localized changes in mechanical properties of the cornea are critical drivers of the morphological behavior observed in the clinic. This hypothesis is driven by strong preliminary data showing remarkable region dependent changes in ectatic corneas in vivo. The proposed research will pursue three specific aims: 1) Validate Brillouin measurements for mechanical evaluation of the cornea; 2) Characterize focal Brillouin modulus changes in subclinical keratoconus; 3) Determine the mechanical impact of refractive surgery and cross-linking procedures on the cornea. The research is significant because elasticity-based metrics will enable early identification of corneal ectasia patients when treatments are maximally beneficial, proper screening of individuals at risk of developing post-operative ectasia that might otherwise undergo LASIK, and objective assessment of the mechanical degradation involved with refractive procedures. Ultimately, the knowledge gained from this research is likely to lead to the development of individualized refractive surgery and cross-linking treatment plans based on the patient's underlying biomechanical status.