Background: It is well known that the biomechanical properties change after LASIK refractive surgery. One reason is the impact of flap creation on the residual stroma. The results have revealed that the change is closely related with the flap thickness in several studies. However, the quantitative relationships between the distributions of displacement and stress on the corneal surface and flap thickness have not been studied. The aim of the study was to quantify evaluate the biomechanical change caused by the LASIK flap. Methods: By building a finite element model of the cornea, the displacement, the stress and the strain on the corneal surface were analyzed. Results: The results showed that the corneal flap could obviously cause the deformation of the anterior corneal surface. For example, the displacement of the corneal vertex achieved 15 μm more than that without corneal flap, when the thickness of corneal flap was 120 μm thick. This displacement was enough to cause the change of aberrations in the human eyes. In the central part of the cornea, the stress on the anterior corneal surface increased with flap thickness. But the change in the stress on the posterior corneal surface was significantly less than that on the anterior surface. In addition, the stress in the central part of the anterior corneal surface increased significantly as the intra-ocular pressure (IOP) increase. Furthermore the increase of IOP had a clearly less effect on stress distribution at the edge of the cornea. Distributions of strain on the corneal surface were similar to those of stress. Conclusions: The changes in the biomechanical properties of cornea after refractive surgery should not be ignored.

A customized myopic refractive surgery was simulated by establishing a finite element model of the human eye,after which we studied the wavefront aberrations induced by biomechanical effects and ablation profile after wavefrontguided LASIK surgery.Methods: Thirty myopia patients (i.e., 60 eyes) without other eye diseases were selected. Their ages, preoperative spherical equivalent, astigmatism, and wavefront aberration were then obtained, in addition to the mean spherical equivalent error range -4 to -8D. Afterward, wavefront-guided customized LASIK surgery was simulated by establishing a finite element eye model, followed by the analysis of the wavefront aberrations induced by the surface displacement from corneal biomechanical effects, as well as customized ablation profile. Finally, the preoperative and induced aberrations were statistically analyzed.Results: Comatic aberrations were the main wavefront abnormality induced by biomechanical effects, and the wavefront aberrations induced by the ablation profile mainly included coma and secondary-coma, as well as sphere and secondarysphere aberrations. Overall, the total high-order aberrations (tHOAs), total coma (C 31 ), and sphere ( 0 4 C ) increased after wavefront-guided customized LASIK surgery. According to our correlation analyses, coma, sphere, and total high-order aberrations were significantly correlated with decentration. Additionally, the material parameters of ocular tissue were found to affect the postoperative wavefront aberrations. When the material parameters of the sclera remained constant but those of cornea increased, the induced wavefront aberrations were reduced. Conclusion:All biomechanical effects of cornea and ablation profile had significant effects on postoperative wavefront aberrations after customized LASIK refractive surgery; however, the effects of the ablation profile were more notorious.Additionally,the characteristics of biomechanical materials have influence on the clinical correction effect.

Purpose A customized myopic refractive surgery was simulated by establishing a finite element model of the human eye,after which we studied the wavefront aberrations induced by biomechanical effects and ablation profile after wavefront-guided LASIK surgery. Methods Thirty myopia patients (i.e., 60 eyes) without other eye diseases were selected. Their ages, preoperative spherical equivalent, astigmatism, and wavefront aberration were then obtained, in addition to the mean spherical equivalent error range − 4 to -8D. Afterward, wavefront-guided customized LASIK surgery was simulated by establishing a finite element eye model, followed by the analysis of the wavefront aberrations induced by the surface displacement from corneal biomechanical effects, as well as customized ablation profile. Finally, the preoperative and induced aberrations were statistically analyzed. Results Comatic aberrations were the main wavefront abnormality induced by biomechanical effects, and the wavefront aberrations induced by the ablation profile mainly included coma and secondary-coma, as well as sphere and secondary-sphere aberrations. Overall, the total high-order aberrations (tHOAs), total coma (C31), and sphere () increased after wavefront-guided customized LASIK surgery. According to our correlation analyses, coma, sphere, and total high-order aberrations were significantly correlated with decentration. Additionally, the material parameters of ocular tissue were found to affect the postoperative wavefront aberrations. When the material parameters of the sclera remained constant but those of cornea increased, the induced wavefront aberrations were reduced. Conclusion All biomechanical effects of cornea and ablation profile had significant effects on postoperative wavefront aberrations after customized LASIK refractive surgery; however, the effects of the ablation profile were more notorious.Additionally,the characteristics of biomechanical materials have influence on the clinical correction effect.