Biomechanical analysis of the keratoconic cornea

Amit Gefen*, Ran Shalom, David Elad, Yossi Mandel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

123 Scopus citations


Keratoconus is a non-inflammatory disease characterized by irregular thinning and gradual bulging of the cornea, which results in distortion of the corneal surface that causes blurred vision. We conducted three-dimensional finite element (FE) simulations to analyze the biomechanical factors contributing to the distorted shape of a keratoconic cornea. We assumed orthotropic linear elastic tissue mechanical properties, and simulated localized tissue thinning (reduction from 0.5 mm to 0.35 or 0.2 mm). We analyzed tissue deformations, stresses and theoretical dioptric power maps predicted by the models, for intraocular pressure (IOP) of 10, 15 20 and 25 mmHg. The analyses revealed that three factors affect the shape distortion of keratoconic corneas: (i) localized thinning, and (ii) reduction in the tissue's meridian elastic modulus or (iii) reduction in the shear modulus perpendicular to the corneal surface, whereas thinning showed the most predominant effect. Maximal stress levels occurred at the centers of the bulged regions, at the thinnest points. The IOP levels had little influence on dioptric power in the healthy cornea, but a substantial influence in keratoconic conditions. The present FE studies allowed characterization of the biomechanical interactions in keratoconus, toward understanding the aetiology of this poorly studied malady.

Original languageEnglish
Pages (from-to)224-236
Number of pages13
JournalJournal of the Mechanical Behavior of Biomedical Materials
Issue number3
StatePublished - Jul 2009


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