Abstract
Only two devices for assessing corneal biomechanics are commercially available, the Ocular Response Analyzer (ORA) and the Corvis ST. Both utilize an air puff as the nondestructive load and both assess biomechanical deformation response of the cornea. However, they differ in strategies for loading with distinct air pressure profiles, as well as for assessing corneal response. The ORA uses an indirect assessment and the Corvis ST uses direct assessment via high-speed imaging. These differences have strong implications on how the data may be interpreted since the corneal biomechanical response depends on the applied load. Details of the differences are discussed in detail, and the devices are directly compared. Each device provides an important and unique biomechanical assessment of the cornea and the data are complimentary rather than competitive in nature.
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References
Luce DA. Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg. 2005;31:156–62.
Ambrósio R Jr, Ramos I, Luz A, Faria-Correia F, Steinmueller A, Krug M, Belin MW, Roberts C. Dynamic ultra-high-speed Scheimpflug imaging for assessing corneal biomechanical properties. Rev Bras Oftalmol. 2013;72(2):99–102.
Andreassen TT, Simonsen AH, Oxlund H. Biomechanical properties of keratoconus and normal corneas. Exp Eye Res. 1980;31:435–44.
Nash IS, Greene PR, Foster CS. Comparison of mechanical properties of keratoconus and normal corneas. Exp Eye Res. 1982;35:413–24.
Jue B, Maurice DM. The mechanical properties of the rabbit and human cornea. J Biomech. 1986;19:847–53.
Hoeltzel DA, Altman P, Buzard K, Choe K. Strip extensiometry for comparison of the mechanical response of bovine, rabbit, and human corneas. J Biomech Eng. 2002;114:202–15.
Palko JR, Liu J. Definitions and concepts. In: Roberts CJ, Liu J, editors. Corneal biomechanics: from theory to practice. Amsterdam: Kugler Publications; 2016. p. 1–24.
Luce D, Taylor D. Ocular response analyzer. In: Roberts CJ, Liu J, editors. Corneal biomechanics: from theory to practice. Amsterdam: Kugler Publications; 2016. p. 67–86.
Roberts CJ. Concepts and misconceptions in corneal biomechanics. J Cataract Refract Surg. 2014;40:862–9.
Glass DH. Characterization of the biomechanical properties of the in vivo human cornea. PhD Dissertation, The Ohio State University; 2008.
Pepose JS, Feigenbaum SK, Qazi MA, Sanderson JP, Roberts CJ. Changes in corneal biomechanics and intraocular pressure following LASIK using static, dynamic and non-contact tonometry. Am J Ophthalmol. 2007;143:39–47.
Hallahan KM, Sinha Roy A, Ambrósio R Jr, Salomao M, Dupps WJ Jr. Discriminant value of custom ocular response analyzer waveform derivatives in keratoconus. Ophthalmology. 2014;121:459–68.
Glass DH, Roberts CJ, Litsky AS, Weber PA. A viscoelastic biomechanical model of the cornea describing the effect of viscosity and elasticity on hysteresis. Invest Ophthalmol Vis Sci. 2008;49(9):3919–26.
Hallahan K, Duups WJ Jr, Roberts CJ. Deformation response to an air puff: clinical methods. In: Roberts CJ, Dupps WJ, Downs JC, editors. Biomechanics of the eye. Amsterdam: Kugler Publications; 2018. p. 199–216.
Kérautret J, Colin J, Touboul D, Roberts C. Biomechanical characteristics of the ectatic cornea. J Cataract Refract Surg. 2008;34(3):510–3.
Vinciguerra P, Albè E, Mahmoud AM, Trazza S, Hafezi F, Roberts CJ. Intra- and postoperative variation in ocular response analyzer parameters in keratoconic eyes after corneal cross-linking. J Refract Surg. 2010;26(9):669–76.
Spoerl E, Terai N, Scholz F, Raiskup F, Pillunat LE. Detection of biomechanical changes after corneal cross-linking using ocular response analyzer software. J Refract Surg. 2011;27:452–7.
Hallahan KM, Rocha K, Roy AS, Randleman JB, Stulting RD, Dupps WJ Jr. Effects of corneal cross-linking on ocular response analyzer waveform-derived variables in keratoconus and postrefractive surgery ectasia. Eye Contact Lens. 2014;40:339–44.
Roberts CJ, Mahmoud AM, Lembach RG, Mauger TF. Corneal deformation characteristics and IOP before and after collagen crosslinking. Invest Ophth Vis Sci. 2013;54:1176.
Mahmoud AM, Roberts CJ, Lembach RG, Twa MD, Herderick EE, McMahon TT, The CLEK study group. CLMI: the cone location and magnitude index. Cornea. 2008;27(4):480–7.
Congdon NG, Broman AT, Bandeen-Roche K, Grover D, Quigley HA. Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol. 2006;141:868–75.
Medeiros FA, Meira-Freitas D, Lisboa R, Kuang T-M, Zangwill LM, Weinreb RN. Corneal hysteresis as a risk factor for glaucoma progression: a prospective longitudinal study. Ophthalmology. 2013;120:1533–40.
Roberts CJ, Mahmoud AM, Bons JP, Hossain A, Elsheikh A, Vinciguerra R, Vinciguerra P, Ambrósio R Jr. Introduction of two novel stiffness parameters and interpretation of air puff induced biomechanical deformation parameters with a dynamic Scheimpflug analyzer. J Refract Surg. 2017;33(4):266–73.
Vinciguerra R, Elsheikh A, Roberts CJ, Ambrósio R Jr, Kang DS, Lopes BT, Morenghi E, Azzolini C, Vinciguerra P. The influence of pachymetry and intraocular pressure on dynamic corneal response parameters in healthy patients. J Refract Surg. 2016;32:550–61.
Metzler K, Mahmoud AM, Liu J, Roberts CJ. Deformation response of paired donor corneas to an air puff: intact whole globe vs mounted corneoscleral rim. J Cataract Refr Surg. 2014;40(6):888–96.
Scarcelli G, Besner S, Pineda R, Yun SH. Biomechanical characterization of keratoconus corneas ex vivo with Brillouin microscopy. Invest Ophthalmol Vis Sci. 2014;55:4490–5.
Vinciguerra R, Ambrósio R Jr, Roberts CJ, Azzolini C, Vinciguerra P. Biomechanical characterization of subclinical keratoconus without topographic or tomographic abnormalities. J Refract Surg. 2017;33(6):399–407.
Vinciguerra R, Ambrósio R Jr, Elsheikh A, Roberts CJ, Lopes B, Morenghi E, Azzolini C, Paolo Vinciguerra P. Dectection of keratoconus with a new biomechanical index. J Refract Surg. 2016;32:803–10.
Ambrósio R Jr, Lopes B, Faria-Correia F, Salomão MQ, Bühren J, Roberts CJ, Vinciguerra R, Vinciguerra P. Integration of Scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection. J Refract Surg. 2017;33:434–43.
Lee H, Roberts C, Kim T-I, Ambrosio R, Elsheikh A, Kang DSY. Changes in biomechanically-corrected intraocular pressure and dynamic corneal response parameters before and after transepithelial photorefractive keratectomy and femtosecond laser-assisted laser in situ keratomileusis. J Cataract Refract Surg. 2017;43(12):1495–503.
Santhiago MR. Percent tissue altered and corneal ectasia. Curr Opin Ophthalmol. 2016;27:311–5.
Fernández J, Rodriguez-Vallejo M, Martinez J, Tauste A, Salvestrini P, Piñero DP. New parameters for evaluating corneal biomechanics and intraocular pressure after small-incision lenticule extraction by Scheimpflug-based dynamic tonometry. J Cataract Refract Surg. 2017;43:803–11.
Vinciguerra R, Romano V, Arbabi E, Brunner M, Willoughby CE, Batterbury M, Kaye SB. In-vivo early corneal biomechanical changes after collagen cross-linking in patients with progressive keratoconus. J Refract Surg. 2017;33:840–6.
Lee H, Roberts C, Ambrósio R, Elsheikh A, Kang DSY, Kim T-I. Effect of accelerated corneal crosslinking combined with transepithelial photorefractive keratectomy on dynamic corneal response parameters and biomechanically corrected intraocular pressure measured with a dynamic Scheimpflug analyzer in healthy myopic patients. J Cataract Refract Surg. 2017;43:937–45.
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Dr. Roberts is a consultant to Oculus Optikgeräte GmbH and Ziemer Ophthalmic Systems AG.
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Roberts, C.J. (2021). Clinical Assessment of Corneal Biomechanics. In: Pallikaris, I., Tsilimbaris, M.K., Dastiridou, A.I. (eds) Ocular Rigidity, Biomechanics and Hydrodynamics of the Eye. Springer, Cham. https://doi.org/10.1007/978-3-030-64422-2_5
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