DOI: 10.32364/2311-7729-2025-25-Suppl-1
E.G. Solodkova1, S.B. Izmailova2, I.N. Zakharov3, V.P. Fokin1, S.V. Balalin1, E.V. Lobanov1, V.A. Sivolobov1, V.H. Le3
1Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Volgograd, Russian Federation
2S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation
3Volgograd State Technical University, Volgograd, Russian Federation
Aim: to analyze results of application of personalized approach to implantation of intracorneal rings (ICR). The technique is based on tailored choice of their size and position, as well as prediction of progressive keratoconus surgery outcomes using a mathematical model of a particular patient's cornea.
Patients and Methods: biomechanical properties of the cornea with keratoconus under external diagnostic procedures were simulated by COMSOL Multiphysics® software. According to the finite element method, three-dimensional images demonstrating distribution of tension and deformity intensities throughout the cornea were obtained. As a result of their comparison with the basic topographic and tomographic maps (Pentacam AXL) along with Corvis ST data (OCULUS Optikgeräte GmbH, Germany), localization, dimensions and severity of deterioration of biomechanical properties of weakened corneal areas were determined. A "digital twin" of the cornea was plotted to select the best option of the ICR's size and position. A scheduled position of the corneal tunnel was achieved by automatic marking on the cornea with an excimer laser. Thus, 30 patients (30 eyes) with keratoconus (stages II and III according to Amsler-Krumeich classification) underwent the surgical intervention. Efficacy and safety of the proposed technique were compared with outcomes of the conventional ICR implantation technique as per the Keraring nomogram in 20 patients (20 eyes) with keratoconus (stages II and III).
Results: results of digital planning of the surgery coincided with post-surgical outcomes. Efficacy of the proposed approach was confirmed by improved BCVA and UCVA (p<0.001), as well as by decreased Kmax and RMS values (p<0.05) that were more pronounced after the modified technique of ICR implantation.
Conclusions: due to modified size and position of a corneal ring, it is possible to control topographic and tomographic corneal characteristics in a flexible way ensuring their best compliance with the target post-surgical parameters.
Keywords: keratoconus, intracorneal rings, mathematical model of the cornea.
For citation: Solodkova E.G., Izmailova S.B., Zakharov I.N., Fokin V.P., Balalin S.V., Lobanov E.V., Sivolobov V.A., V.H. Lе. Streamlined approach to corneal ring implantation based on mathematical modeling. Russian Journal of Clinical Ophthalmology. 2025;25(Special Issue):7–18 (in Russ.). DOI: 10.32364/2311-7729-2025-25-Suppl-1
About the authors:
Elena G. Solodkova — C. Sc. (Med.), Deputy Director for Scientific Work, Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 80, Zemlyachka str., Volgograd, 400138, Russian Federation; ORCID iD 0000-0002-7786-5665
Svetlana B. Izmailova — Dr. Sc. (Med.), Head of the Department of Transplantation and Opto-Reconstructive Surgery of the Anterior Segment of the Eyeball, S. Fyodorov Eye Microsurgery Federal State Institution; 59a, Beskudnikovskii blvd., Moscow, 127486, Russian Federation; ORCID iD 0000-0002-3516-1774
Igor N. Zakharov — Dr. Sc. (Tech.), Head of the Department of Structural Performance of Materials, Volgograd State Technical University; 28, V.I. Lenin ave., Volgograd, 400005, Russian Federation; ORCID iD 0000-0001-7177-7245
Viktor P. Fokin — Dr. Sc. (Med.), Professor, Chief Specialist of the Organizational and Methodological Department, Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 80, Zemlyachka str., Volgograd, 400138, Russian Federation; ORCID iD 0000-0002-2513-9709
Sergei V. Balalin — Dr. Sc. (Med.), Head of the Scientific Department, Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 80, Zemlyachka str., Volgograd, 400138, Russian Federation; ORCID iD 0000-0002-5250-3692
Evgenii V. Lobanov — Engineer, Department of Medical Equipment Maintenance, Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 80, Zemlyachka str., Volgograd, 400138, Russian Federation; ORCID iD 0000-0001-9112-3230
Vitalii A. Sivolobov — Engineer, Department of Medical Equipment Maintenance, Volgograd Branch of the S. Fyodorov Eye Microsurgery Federal State Institution; 80, Zemlyachka str., Volgograd, 400138, Russian Federation; ORCID iD 0009-0001-6347-2449
Le Van Hoang — Postgraduate Student, Department of Structural Performance of Materials, Volgograd State Technical University; 28, V.I. Lenin ave., Volgograd, 400005, Russian Federation; ORCID iD 0000-0002-1536-3061
Contact information: Elena G. Solodkova, e-mail: mntk@isee.ru
Financial Disclosure: the study was funded by a grant from the Russian Science Foundation (Grant No. 25-25-00303, https://rscf.ru/project/25-25-00303/).
There is no conflict of interest.
Received 11.11.2024.
Revised 04.12.2024.
Accepted 27.12.2024.
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