The purpose of this study was to investigate the depth-dependent biomechanical properties of the human corneal stroma under uniaxial tensile loading. Human stroma samples were obtained after the removal of Descemet's membrane in the course of Descemet's membrane endothelial keratoplasty (DMEK) transplantation. Uniaxial tensile tests were performed at three different depths: anterior, central, and posterior on 2 x 6 × 0.15 mm strips taken from the central DMEK graft. The measured force-displacement data were used to calculate stress-strain curves and to derive the tangent modulus. The study showed that mechanical strength decreased significantly with depth. The anterior cornea appeared to be the stiffest, with a stiffness approximately 18% higher than that of the central cornea and approximately 38% higher than that of the posterior layer. Larger variations in mechanical response were observed in the posterior group, probably due to the higher degree of alignment of the collagen fibers in the posterior sections of the cornea. This study contributes to a better understanding of the biomechanical tensile properties of the cornea, which has important implications for the development of new treatment strategies for corneal diseases. Accurate quantification of tensile strength as a function of depth is critical information that is lacking in human corneal biomechanics to develop numerical models and new treatment methods.

To evaluate variability of central corneal thickness measurement (CCT) devices using a hitherto unprecedented number of CCT devices. CCT was measured consecutively in 122 normal corneas of 61 subjects with seven different devices using three distinct measurement technologies: Scheimpflug, Ultrasound, and Optical Coherence Tomography (OCT). Per device deviation from the mean CCT value per eye was used to determine which of the devices performed best, compared to the mean value. Cirrus OCT yielded the lowest deviation. Deviations of the individual devices from the mean CCT of each eye were (OS/OD) 12.8±5.0/14.9±9.4 μm for Topcon noncontact specular microscopy (NCSM), 11.3±5.9/10.6±7.3 μm for Pentacam, 10.7±5.2/10.4±4.8 μm for Spectralis OCT, 6.0±3.9/6.2±4.9 μm for Topcon DRI OCT, 5.1±3.4/5.9±10.3 μm for AngioVue OCT, 4.8±4.1/5.7±4.6 μm for US pachymetry, and 4.2±3.2/5.7±4.6 μm for Cirrus OCT. The maximum differences between US pachymetry and the other devices were very high (up to 120 μm). Central corneal thickness may be under- or overestimated due to high interdevice variations. Measuring CCT with one device only may lead to inappropriate clinical and surgical recommendations. OCT showed superior results.

Laser Assisted in Situ Keratomileusis (LASIK) is a proven treatment method for corneal refractive surgery. Surgically induced higher order optical aberrations were a major reason why the method was only rarely used to treat presbyopia, an age-related near-vision loss. In this study, a novel customization algorithm for designing multifocal ablation patterns, thereby minimizing induced optical aberrations, was used to treat 36 presbyopic subjects. Results showed that most candidates went from poor visual acuity to uncorrected 20/20 vision or better for near (78%), intermediate (92%), and for distance (86%) vision, six months after surgery. All subjects were at 20/25 or better for distance and intermediate vision, and a majority (94%) were also better for near vision. Even though further studies are necessary, our results suggest that the employed methodology is a safe, reliable, and predictable refractive surgical treatment for presbyopia.

A study to compare femto-presbyLASIK to standard myopia femto-LASIK refractive surgical correction with a total of 45 candidates was performed. The goal was to identify a more specific set of indications for presbyopia LASIK treatments. The results showed thoroughly good uncorrected visual acuity for myopia (decimal: 1.01 ± 0.15) as well as for presbyLASIK (decimal: 0.78 ± 0.17) corrections. Astigmatism was comparable in both groups and did not change significantly from preoperative (0.98D ± 0.53 SD) to postoperative (1.01D ± 0.50 SD). Our study results suggest, that presbyLASIK treatment is as safe and effective as regular LASIK myopia correction and can hence be recommended to treat presbyopia.

Pterygium is a vascularized, invasive transformation on the anterior corneal surface that can be treated by Strontium-/Yttrium90 beta irradiation. Finite element modeling was used to analyze the biomechanical effects governing the treatment, and to help understand clinically observed changes in corneal astigmatism. Results suggested that irradiation-induced pulling forces on the anterior corneal surface can cause astigmatism, as well as central corneal flattening. Finite element modeling of corneal biomechanics closely predicted the postoperative corneal surface (astigmatism error −0.01D; central curvature error −0.16D), and can help in understanding beta irradiation treatment. Numerical simulations have the potential to preoperatively predict corneal shape and function changes, and help to improve corneal treatments.

Die Xenotransplantation von humanem Schilddrüsengewebe auf Nacktmäuse bietet die Möglichkeit, die Wirkung von Thyreoidea-stimulierenden Immunglobulinen (TSI) auf das Schilddrüsengewebe verschiedener Spezies vergleichend zu studieren. In der vorliegenden Arbeit zeigen wir, daß von 8 Basedow-Seren nur eines die Radiojodaufnahme der Mäuseschilddrüsen stimuliert, während alle 8 Seren die Radiojodaufnahme im xenotransplantierten humanen Schilddrüsengewebe stimulieren. Diese Resultate belegen klar einen speziesspezifischen Effekt von TSI. Administration of sera from patients with active Graves' disease to nude mice bearing human thyroid xenografts provides the opportunity to compare directly the effects of TSAb on thyroid tissue of different species. The results presented in this paper, namely the fact that only one of 8 Graves' sera increased the RAIU of the nu/nu mouse thyroids modestly while all sera increased the RAIU in the transplanted human tissue considerable, clearly show a species specific effect of TSAb.