Viscoelastic properties of porcine lenses using optical coherence elastography and inverse finite element analysis.

The mechanical properties of the crystalline lens are crucial in determining the changes in lens shape that occur during the accommodation process and are also a major factor in the development of the two most prevalent age-related diseases of the lens, presbyopia and cataracts. However, a comprehensive understanding of these properties is currently lacking. Previous methods for characterizing the mechanical properties of the lens have been limited by the amount of data that could be collected during each test and the lack of complex material modeling. These limitations were mainly caused by the lack of imaging techniques that can provide data for the entire crystalline lens and the need for more complex models to describe the non-linear behavior of the lens. To address these issues, we characterized the mechanical properties of 13 porcine lenses during an ex vivo micro-controlled-displacement compression experiment using optical coherence elastography (OCE) and inverse finite element analysis (iFEA). OCE allowed us to quantify the internal strain distribution of the lens and differentiate between the different parts of the lens, while iFEA enabled us to implement an advanced material model to characterize the viscoelasticity of the lens nucleus and the relative stiffness gradient in the lens. Our findings revealed a pronounced and rapid viscoelastic behavior in the lens nucleus (g1 = 0.39 ± 0.13, τ1 = 5.01 ± 2.31 s) and identified the lens nucleus as the stiffest region, with a stiffness 4.42 ± 1.20 times greater than the anterior cortex and 3.47 ± 0.82 times greater than the posterior cortex. However, due to the complex nature of lens properties, it may be necessary to employ multiple tests simultaneously for a more comprehensive understanding of the crystalline lens.

Quantification of scleral changes during dynamic accommodation.

The mechanics of accommodation is a complex process that involves multiple intraocular ocular structures. Recent studies suggest that there is deformation of the sclera during accommodation that may also play a role in accommodation, influencing ciliary muscle contraction and contributing to the accommodative response. However, the type and magnitude of the deformations measured varies significantly across studies. We present high-resolution synchronous OCT measurements of the anterior sclera contour and thickness and lens thickness acquired in real-time during accommodative responses to 4D step stimuli. The lens thickness was used as an assessment of objective accommodation. No changes in nasal and temporal anterior scleral contour and scleral thickness were found during accommodation within the precision of our measurements. Our results demonstrate that there are no significant scleral deformations during accommodation.

A validated finite element model to reproduce Helmholtz's theory of accommodation: a powerful tool to investigate presbyopia.

PURPOSE: To reproduce human in vivo accommodation numerically. For that purpose, a finite element model specific for a 29-year-old subject was designed. Once the proposed numerical model was validated, the decrease in accommodative amplitude with age was simulated according to data available in the literature. METHODS: In contrast with previous studies, the non-accommodated eye condition was the reference configuration. Consequently, two aspects were specifically highlighted: contraction of the ciliary muscle, which was simulated by a continuum electro-mechanical model and incorporation of initial lens capsule stresses, which allowed the lens to become accommodated after releasing the resting zonular tension. RESULTS: The morphological changes and contraction of the ciliary muscle were calibrated accurately according to the experimental data from the literature. All dynamic optical and biometric lens measurements validated the model. With the proposed numerical model, presbyopia was successfully simulated. CONCLUSIONS: The most widespread theory of accommodation, proposed by Helmholtz, was simulated accurately. Assuming the same initial stresses in the lens capsule over time, stiffening of the lens nucleus is the main cause of presbyopia.

Evaluation of the mechanical stability of intraocular lenses using digital image correlation.

This study aimed to evaluate the mechanical stability of seven different intraocular lens (IOL) haptic designs by using digital image correlation to measure their mechanical biomarkers (axial displacement, tilt, and rotation) under quasi-static compression. The IOLs were compressed between two clamps from 11.00 up to 9.50 mm whilst a 3D deformation dataset was acquired every 0.04 mm. Results revealed that flexible and mixed IOL designs exhibited better mechanical response for smaller compression diameters compared to stiff designs. Conversely, stiff designs performed better for larger compression diameters. These findings may aid in the selection and development of more mechanically stable IOL designs.

Automated segmentation of the ciliary muscle in OCT images using fully convolutional networks.

Quantifying shape changes in the ciliary muscle during accommodation is essential in understanding the potential role of the ciliary muscle in presbyopia. The ciliary muscle can be imaged in-vivo using OCT but quantifying the ciliary muscle shape from these images has been challenging both due to the low contrast of the images at the apex of the ciliary muscle and the tedious work of segmenting the ciliary muscle shape. We present an automatic-segmentation tool for OCT images of the ciliary muscle using fully convolutional networks. A study using a dataset of 1,039 images shows that the trained fully convolutional network can successfully segment ciliary muscle images and quantify ciliary muscle thickness changes during accommodation. The study also shows that EfficientNet outperforms other current backbones of the literature.

Biomechanical Stability of Three Intraocular Lenses With Different Haptic Designs: In Silico and In Vivo Evaluation.

PURPOSE: To assess the biomechanical stability of three different marketed intraocular lenses (IOLs) with different haptic designs (four-loop IOL [Micro F FineVision model] and double C-loop IOL [POD F and POD FT models], all manufactured by PhysIOL), in silico (computer simulation) and in vivo (in the context of lens surgery). METHODS: An in silico simulation investigation was performed using finite element modeling (FEM) software to reproduce the compression test defined by the International Organization for Standardization and in vivo implantation in patients in the context of lens surgery was evaluated 1 day and 3 months postoperatively. IOL decentration and rotation were tested. In addition, the stress and strains were analyzed with the finite element method. RESULTS: In the in silico evaluation, the compression force for the POD F IOL was slightly lower than for the POD FT IOL and Micro F IOL for all compression diameters. The axial displacement was maximum for the POD FT IOL and the tilt, rotation, and lateral decentration were substantially lower than the acceptable tolerance limits established in ISO 11979-2. In the in vivo evaluation, a total of 45 eyes from 45 patients were selected, 15 eyes for each IOL model under assessment. Statistically significant differences were found between the Micro F and POD F IOLs for lateral decentration in x-direction (in absolute value) at 3 months postoperatively (P = .03). CONCLUSIONS: Although statistically significant differences have been found when comparing the displacement, tilt, and rotation between the different lenses, these differences cannot be considered clinically relevant, which would suggest that all three IOL models yield excellent stability in those terms. FEM appears to be a powerful tool for numerical studies of the biomechanical properties of IOLs. [J Refract Surg. 2020;36(9):617-624.].

Influence of material and haptic design on the mechanical stability of intraocular lenses by means of finite-element modeling.

Intraocular lenses (IOLs) are used in the cataract treatment for surgical replacement of the opacified crystalline lens. Before being implanted they have to pass the strict quality control to guarantee a good biomechanical stability inside the capsular bag, avoiding the rotation, and to provide a good optical quality. The goal of this study was to investigate the influence of the material and haptic design on the behavior of the IOLs under dynamic compression condition. For this purpose, the strain-stress characteristics of the hydrophobic and hydrophilic materials were estimated experimentally. Next, these data were used as the input for a finite-element model (FEM) to analyze the stability of different IOL haptic designs, according to the procedure described by the ISO standards. Finally, the simulations of the effect of IOL tilt and decentration on the optical performance were performed in an eye model using a ray-tracing software. The results suggest the major importance of the haptic design rather than the material on the postoperative behavior of an IOL. FEM appears to be a powerful tool for numerical studies of the biomechanical properties of IOLs and it allows one to help in the design phase to the manufacturers.