A predictive model of UV-A-riboflavin crosslinking treatment on porcine corneas

IF 2.9 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences Pub Date : 2023-11-01 DOI:10.1098/rspa.2023.0323
Alessandra Bonfanti, Anna Pandolfi
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Abstract

The crosslinking technique (CXL) is an effective low-risk therapeutic treatment of keratoconus and other ectatic disorders of the human cornea. The effect of corneal CXL is to increase the stiffness of the stroma to prevent the progression of the cornea distortion. Several clinical and experimental studies have shown that the stiffening effects predominantly localize on the anterior portion of the stroma and that the in-depth stiffening distribution is highly dependent on the duration of treatment. Yet, how the stiffening effects distribute through the cornea thickness as a function of the treatment duration is an open question. Here, we propose an analytical model of the stiffening profile due to CXL treatment as a function of the irradiation time. We consider linear and nonlinear variations of the crosslinking effects across the thickness and implement them into a finite element model of the porcine cornea. We present a time-dependent in-depth stiffening profile that allows us to predict the post-operative cornea response to physiological intraocular pressure for different irradiation times. We anticipate that this predictive model will support the development of patient specific three-dimensional models that will allow clinicians to design customized CXL treatment, thus enhancing treatment outcomes.
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uv -A-核黄素交联治疗猪角膜的预测模型
交联技术(CXL)是一种有效的低风险治疗圆锥角膜和其他人类角膜扩张疾病的方法。角膜CXL的作用是增加角膜基质的硬度,防止角膜畸变的发展。一些临床和实验研究表明,硬化效应主要局限于基质的前部,而深度硬化分布高度依赖于治疗的持续时间。然而,硬化效应如何通过角膜厚度作为治疗持续时间的函数分布是一个悬而未决的问题。在这里,我们提出了一个解析模型的强化轮廓由于CXL处理作为辐照时间的函数。我们考虑了交联效应在厚度上的线性和非线性变化,并将其实现到猪角膜的有限元模型中。我们提出了一个时间依赖的深度硬化剖面,使我们能够预测手术后角膜对不同照射时间的生理眼内压的反应。我们预计该预测模型将支持患者特定三维模型的发展,这将允许临床医生设计定制的CXL治疗,从而提高治疗效果。
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来源期刊
CiteScore
6.40
自引率
5.70%
发文量
227
审稿时长
3.0 months
期刊介绍: Proceedings A has an illustrious history of publishing pioneering and influential research articles across the entire range of the physical and mathematical sciences. These have included Maxwell"s electromagnetic theory, the Braggs" first account of X-ray crystallography, Dirac"s relativistic theory of the electron, and Watson and Crick"s detailed description of the structure of DNA.
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