Keratoconus is a structural cornea disorder due to a combination of genetic, environmental and hormonal variables that leads toa gradual thinning and outward protrusion of the cornea that in initial phases can be treated with cross-linking (CXL) techniques to make the cornea stronger. CXL involves placing riboflavin on the corneal surface and then applying UV-A light to enhance the bonding between collagen fibers within the cornea. The analysis of treatment performance over time can be carried out using personalized digital corneal models that incorporate the mechanical alterations induced by CXL. For this purpose, a variation of the parameters that define the stiffness contribution in hyperelastic materials can be considered. The development of computational corneal models opens the possibility to analyze the local effect of CXL techniques with the development of sectorized in-silico patient specific model where different materials can be considered in different zones optimizing the riboflavin use and the effectiveness of the treatment. The possibility to vary the stiffness in the thickness can also contribute to simulate with more accuracy the real effects of CXL techniques. Computational models can contribute to create a digital twin of corneas with CXL treatment facilitating follow-up and evolution after treatment of these ones.

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Digital Twins Models Applied to CXL Treatments of Corneas Affected with Keratoconus

  • José González-Cabrero,
  • Carmelo Gómez,
  • Francisco Cavas

摘要

Keratoconus is a structural cornea disorder due to a combination of genetic, environmental and hormonal variables that leads toa gradual thinning and outward protrusion of the cornea that in initial phases can be treated with cross-linking (CXL) techniques to make the cornea stronger. CXL involves placing riboflavin on the corneal surface and then applying UV-A light to enhance the bonding between collagen fibers within the cornea. The analysis of treatment performance over time can be carried out using personalized digital corneal models that incorporate the mechanical alterations induced by CXL. For this purpose, a variation of the parameters that define the stiffness contribution in hyperelastic materials can be considered. The development of computational corneal models opens the possibility to analyze the local effect of CXL techniques with the development of sectorized in-silico patient specific model where different materials can be considered in different zones optimizing the riboflavin use and the effectiveness of the treatment. The possibility to vary the stiffness in the thickness can also contribute to simulate with more accuracy the real effects of CXL techniques. Computational models can contribute to create a digital twin of corneas with CXL treatment facilitating follow-up and evolution after treatment of these ones.