September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Patient-Specific Computational Analysis of Laser in situ Keratomileusis: A clinical validation study
Author Affiliations & Notes
  • Ibrahim Seven
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Mayfield Hts, Ohio, United States
  • Ali Vahdati
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Mayfield Hts, Ohio, United States
  • William J Dupps
    Ophthalmology, Cleveland Clinic Cole Eye Institute, Mayfield Hts, Ohio, United States
  • Footnotes
    Commercial Relationships   Ibrahim Seven, None; Ali Vahdati, None; William Dupps, Cleveland Clinic/Optoquest (P)
  • Footnotes
    Support  R01 EY023381, Ohio Third Frontier Innovation Platform Award TECH 13-059, Unrestricted Grant from Research to Prevent Blindness to the Dept. of Ophthalmology of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2376. doi:
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    • Get Citation

      Ibrahim Seven, Ali Vahdati, William J Dupps; Patient-Specific Computational Analysis of Laser in situ Keratomileusis: A clinical validation study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2376.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To develop a microstructural based, 3D, patient specific, finite element model (FEM) of LASIK and compare the outcomes of the simulations to actual post-LASIK follow-up tomographies.

Methods : Patient-specific tomographic data from 20 eyes of 12 patients undergoing sphero-cylindrical LASIK treatment were meshed including epithelium, flap, wound, and residual stromal bed using a custom meshing software. Case-specific treatment settings were simulated. Simulated keratometry values (SimK) including the average curvature of the steep (K1), flat (K2) meridians, and central 3mm circular region (Kmean) were obtained from the anterior surfaces of both the actual tomographies and their generated FEMs. Mean difference (MD) and mean absolute difference (MAD) between these values were calculated to assess prediction error. Pearson correlation values (R) between individual errors in predicted Kmean and age, corneal hysteresis (CH), and corneal resistance factor (CRF) were calculated.

Results : MD and MAD between simulated and actual post-LASIK cases were -0.13 ± 0.36 D and 0.28 ± 0.25 D respectively. The differences between simulated and actual SimK values were not statistically significant (p values for Kmean=0.1, K1=0.4, K2=0.5). R values between the individual differences in Kmean and CH, CRF, and age were 0.63, 0.53, and -0.5, respectively (p = 0.004, = 0.01, and = 0.02, respectively).

Conclusions : The investigated computational modeling approach demonstrated low prediction errors and may be useful for clinical guidance in planning LASIK. Clinical biomechanical metrics and surrogates explain some of the variance in prediction error and may be useful to tailor generic material properties into patient specific material properties to increase prediction accuracy.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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