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Keratoconus prognosis study for patients with corneal external mechanical stress mode

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Abstract

Purpose

To demonstrate the correlation between excessive eye rubbing and corneal degeneration for Keratoconus patients.

Materials and methods

Keratoconus (KC) patients who regularly rub their eyes had shown a rapid degeneration rate of their affected corneas. This observation is experimentally and numerical discussed and developed based on clinical data of 8 of KC Patients with a mean age of 26.5 ± 9.4 years old, and four healthy individuals with a mean age of 24.33 ± 5 years old at the baseline. Corneal topography was used to measure both central corneal thickness (CCT) and its total refractive power. The registered data had been exploited to assess the progression of the disease, and the final results were embedded in a finite element model of human corneas to simulate their response to eye rubbing at different stages of the pathology. Corneal lifetime prognosis using multi-layer perceptron was then established to estimate the number of eye rubbing cycles for each stage of KC.

Results

The survey of KC patients who declared stopping eye rubbing had shown a decrease in CCT loss rate, followed by a durable stability. Mechanical stresses numerical simulations had shown different corneal behaviours in term of shape deformity, apical raise and corneal applanation between healthy and KC stages models. Apical rise ranged from 0.122 to 0.389 mm for an applied intraocular pressure that equals to 15 mmHg. A normal stress of 5 kPa provoked a corneal applanation that ranged from 0.27 mm in healthy cases to 1.173 mm in severe stages of the disease. The application of 2.5 kPa biaxial stress had resulted normal and tangential applanations that successively ranged from 0.152 and 0.173 mm in healthy corneas to 0.446 mm and 0.458 mm in severe KC stages. An adopted prognosis algorithm was able to predict the current stage of the disease and to estimate the remaining number of eye rubbing cycles before failure.

Conclusion

Eye rubbing was proven to be a considerable contributing factor in KC patient’s corneal degeneration. The progression of this pathology could be decreased or halted by stopping eye rubbing at early stages.

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Acknowledgements

The authors show gratitude and respect to Dr AOUATI Abdelouaheb and all the staff of EL BASSIRA ophthalmology clinic in Algeria, for their collaboration and their kindness.

Funding

This study was not funded by any organization.

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Authors and Affiliations

  1. Laboratory of Solid Mechanics and Systems, Mhamed Bougara University, Boumerdes, Algeria

    Toufik Bettahar, Chemseddine Rahmoune & Djamel Benazzouz

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  1. Toufik Bettahar
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  2. Chemseddine Rahmoune
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  3. Djamel Benazzouz
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Corresponding author

Correspondence to Toufik Bettahar.

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All authors declare not having any conflict of interest with any part or any other research team.

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This work is compliant with the National Ethical Standards of Scientific Research and accordant with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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This article does not contain any studies with human participants or animals performed by any of the authors (except for the data gathered from EL BASSIRA Ophthalmology clinic that was provided under an anonymous pattern.)

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Bettahar, T., Rahmoune, C. & Benazzouz, D. Keratoconus prognosis study for patients with corneal external mechanical stress mode. Int Ophthalmol 40, 1673–1686 (2020). https://doi.org/10.1007/s10792-020-01335-2

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  • DOI: https://doi.org/10.1007/s10792-020-01335-2

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