Biomechanics of the Human Eye and Intraocular Pressure Measurements

Sammanfattning: This thesis addresses the reliability of Goldmann-type applanation tonometers (GAT). It deals with the investigation of the relation between predicted intraocular pressure, IOPG and true pressure, IOPT. The problem of the accuracy of GAT readings has acquired special importance over the last two decades as new types of surgical procedures to correct vision disorders are being explored and gain universal acceptance. The overall aim of the present study is to assess the effects of individual variations in the corneal central thickness (CCT), material properties of the involved tissues and paracentral applanation on the accuracy of IOPG.Two finite element models have been constructed: a two-dimensional axisymmetric model of the cornea and a three-dimensional model of the whole corneoscleral envelope. Various material descriptions were adopted for the cornea in 2D, whereas the 3D model accounted for collagen microstructure and represented a hyperelastic ber reinforced material. Nonlinear analyses were carried out using the commercial general-purpose finite element software ABAQUS. An extensive literature survey and consultations with ophthalmologists and clinicians were the platform for establishing relevant modelling procedures.The results reveal a clear association between all considered parameters and measured IOPG. The effect of assumed CCT is highly dependent on the corneal material properties. Material model alone has a profound effect on predicted IOPG. Variations in tonometer tip application produce clinically signi cant errors to IOPG measurements. Potential effects of corneal stiffness and paracentral applanation on GAT readings are larger than the impact of CCT. The behaviour of the models is broadly in agreement with published observations. The proposed procedures can be a useful tools for suggesting the magnitudes of corrections for corneal biomechanics and possible human errors. The present modelling exercise has an ability to reproduce the behaviour of human cornea and trace it under IOP and GAT, providing potentially useful information on the distribution of stresses and strains. Some recommendations can be drawn in pursuit of the clinical imperatives of ophthalmologists.