Refractive interventions are widespread techniques for vision correction such as myopia or astigmatism. The cornea of the patient is reshaped by surgical intervention like incisions and laser ablation of stromal tissue. The amount of tissue to remove is traditionally estimated based on experimental nomograms or geometrical approaches. Unfortunately, the change of corneal power is frequently over- or under-estimated.
We proposed an opto-mechanical simulation framework to quantify the optical outcome induced by alteration of the corneal biomechanics. This numerical framework was used to perform personalized simulations of different surgical procedures such as corneal ring implantation and arcuate keratotomy. For example, arcuate keratotomy is a surgical technique used to correct astigmatism following cataract interventions. Our numerical simulation framework could estimate the outcome of different planning options before the surgery. Based on this numerical approach, we were also able to propose optimization algorithms to automatically determine the surgical parameters optimal for each specific patient. The patient-specific optimization of the surgery proved to better control the outcome of the intervention, leads to more reliable postoperative astigmatism, and limits the risks of overcorrection.