Biomechanical model of corneal transplantation.

PURPOSE: Refractive consequences of corneal transplants are analyzed using corneal biomechanical models assuming homogeneous and inhomogeneous stiffness distributions across the cornea. Additionally, refractive effects of grafts combined with volume removal procedures are also evaluated to develop methods to reduce postoperative refractive management of patients. METHODS: Refinements of a two-dimensional finite element model are applied to simulate the biomechanical and refractive effects of different corneal transplant procedures: anterior lamellar keratoplasty, posterior lamellar keratoplasty, and penetrating keratoplasty. The models are based on a nonlinearly elastic, isotropic formulation. Predictions are compared with published clinical data. RESULTS: The model simulating the penetrating keratoplasty procedure predicts more change in the postoperative corneal curvature than models simulating anterior lamellar keratoplasty or posterior lamellar keratoplasty procedures. When a lenticle-shaped tissue with a central thickness of 50 microns and a diameter of 4 mm is removed from the anterior corneal surface along with the anterior lamellar keratoplasty or posterior lamellar keratoplasty, the models predict a refractive correction of -8.6 and -8.9 diopters, respectively. CONCLUSIONS: Simulations indicate that a posterior lamellar keratoplasty procedure is preferable for obtaining a better corneal curvature profile, eliminating the need for specific secondary treatments.

A tissue phantom for investigating volume quantification on retinal images obtained with the Stratus OCT system.

The performance of the Stratus OCT system in extracting shape and volume of retinal lesions was investigated by scanning a tissue phantom containing specific enclosed geometric gaps of known size. Measurements were made by filling the gaps with an aqueous suspension containing a fixed tissue suspended in phosphate-buffered saline inside the gaps. OCT raw data was exported for subsequent analysis using custom software written in MATLAB software platform. An active contour model was used to outline the boundaries of the fixed tissue on OCT images of the tissue phantom. Images provided by the OCT system were analyzed with the custom software and later compared with the actual geometric parameters of the tissue phantom. An active contour model is effective in detecting the boundaries of the tested object and accurately estimating its volume. We show that a tissue phantom provides an easy and reproducible method of verifying the accuracy and precision of specific features in the images retrieved by the Stratus OCT system.

Some limitations of spatio temporal source models.

The spatio temporal source model (STSM) interprets the successive scalp topographies of an electrophysiological event as the summed activity of a few fixed generators. This modeling methodology is expected to provide a unique solution for a fixed number of sources. Because in general there is no "a priori" available physiological information, independent criteria need to be applied for determining the correct number of sources (Ns). This study illustrates theoretically as well as in simulations, that the existence of a unique solution can only be claimed when Ns is known a priori. Since most of the methods proposed for estimate Ns are not accurate as illustrated here, STSM may result in unpredictable non-physiological solutions. Basic modeling aspects and additional factors affecting reliability of STSM such as those related to the optimization process associated to the source parameter search are discussed. Some of the possible inverse solutions are illustrated in our simulations. Our main conclusion is the need to improve STSM before claims about neural generator localization can be accepted. We will also discuss, how attempts to apply STSM to clinical data, apparently supporting their reliability, are plagued with incorrect assumptions and do not justify the expectancy aroused about such models. We discuss some ways for improving STSM and the need to develop measures to evaluate their reliability, independent of the physiological plausibility of the solutions obtained. Finally we propose two mathematical measures that can be incorporated to the optimization process to contribute to the evaluation of its performance.