The stiffness of the human cornea increases by a factor of approximately two between the ages of 20 and 100 years. This variation is relevant to the algorithms used to predict the response to incisional and ablative refractive surgery and will also affect the formulas used to calculate intraocular pressure by applanation.

Results show that in the formation of the microkeratome flap, collagen fibers are severed and minimal biomechanical loading is distributed through the flap. Corneal biomechanical integrity is compromised after microkeratome incisions.

PURPOSE: To study the corneal biomechanical effects of varying LASIK flap depth and side cut angulations and evaluate the relative contribution of the lamellar and side cuts using a femtosecond laser and radial shearing speckle pattern interferometry (RSSPI). METHODS: Forty-two organ-cultured human corneas were divided into a control group and three investigative groups, each undergoing different incision types at both 90- and 160-μm depth using a femtosecond laser. In the first group, typical LASIK flaps were created; in the second group, only the bed was cut (delamination); and in the third group, side cuts alone were affected. Corneal strain was measured using RSSPI before and after treatment following an increase in hydrostatic pressure from 15.0 to 15.5 mmHg and again after 1 week of incubation in culture medium. RESULTS: The flap group demonstrated a weakening of strength related to the depth of cut, with strain increasing by 9% and 32% at 90 and 160 μm, respectively. Similar changes, 9% and 33%, were observed following execution of side cuts to the same depths. By contrast, strain increase following delamination showed no relationship with depth, increasing by 5% in both instances. When the side cut angle was made more acute, strain decreased with a 2% strain increase being measured after a 90-μm, 150° side cut was created. No significant changes occurred during the period of organ culture. CONCLUSIONS: Vertical side cuts through corneal lamellae rather than horizontal delamination incisions contribute to the loss of structural integrity during LASIK flap creation. Angulating side cuts such that the stromal diameter of the flap exceeds its epithelial diameter can decrease this effect.

No abstract

Measurement of plane-strain surface displacement with ESPI requires at least two in-plane illumination geometries. For static loading conditions it is acceptable to record these two interferograms sequentially. However, for time-dependent strain fields, it is necessary to use both illumination geometries simultaneously so that a recording is made with identical strain conditions existing for both. The authors describe a new interferometer that has been devised to measure two in-plane interferograms at the same time. The determination of the method of operation and experimental verification of the technique are given.