Multiscale Integrative Approach for Corneal Biomechanics to Assess Corneal Crosslinking

Objetivo

Approximately 250 million people worldwide are visually impaired, and this has great economic and social impact. One of the pathologies of vision loss is keratoconus, in which the mechanical balance of the cornea depending on intraocular pressure and internal stresses in corneal tissue becomes imbalanced, which can result in a corneal protrusion.

Corneal crosslinking (CXL) is a clinical treatment that increases the overall mechanical stiffness of the cornea by inducing chemical bounding between collagen molecules. CXL is the present of halting corneal ectasias, and the future of noninvasive refractive surgery. However, its micro/nano-mechanisms are not completely understood. Moreover, CXL is usually applied uniformly in corneal treatments, which can result in over-stiffening and unexpected postsurgical outcomes.

Ophthalmology can benefit from in silico modeling to plan and improve such interventions. However, current computational models are mainly macroscopic and cannot simulate complex phenomena involved in CXL. Multiscale computational models could improve clinical strategies by including information at different scales.

MIMetiCO’s goal is to combine experiments and modelling at different scales to provide a multiscale characterization of corneal biomechanics before and after CXL. This characterization will rely on both ground-breaking and well-established technologies that include confocal microscopy, biochemical assessment, and mechanical inflation tests to determine morphological (orientation and density of fibrils), biochemical (amount of intermolecular crosslinks), and mechanical features of the cornea.

MIMetiCO will use this information to calibrate the first in silico model of the cornea using a multiscale structural approach to build a virtual framework to simulate potential CXL treatments.

MIMetiCO is the next step in ophthalmology, which has the potential to bring into being a new generation of clinical assessment.