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July 23, 2024
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Fluid-Structure Interaction Based Algorithms for IOP and Corneal Material Behavior

Publicated to:Frontiers In Bioengineering And Biotechnology. 8 - 2020-01-01 8(), DOI: 10.3389/fbioe.2020.00970

Authors: Maklad O; Eliasy A; Chen K-J; Wang J; Abass A; Lopes BT; Theofilis V; Elsheikh A

Affiliations

Eye Hospital and The Institution of Ocular Biomechanics; Wenzhou Medical University; Wenzhou; China - Author
School of Engineering; University of Liverpool; Liverpool; United Kingdom - Author
School of Engineering; University of Liverpool; Liverpool; United Kingdom; Beijing Advanced Innovation Center for Biomedical Engineering; Beihang University; Beijing; China; NIHR Biomedical Research Centre for Ophthalmology; Moorfields Eye Hospital NHS Fo - Author

Abstract

Purpose: This paper presents and clinically validates two algorithms for estimating intraocular pressure (IOP) and corneal material behavior using numerical models that consider the fluid-structure interaction between the cornea and the air-puff used in non-contact tonometry. Methods: A novel multi-physics fluid-structure interaction model of the air-puff test was employed in a parametric numerical study simulating human eyes under air-puff pressure with a wide range of central corneal thickness (CCT = 445–645 μm), curvature (R = 7.4–8.4 mm), material stiffness and IOP (10–25 mmHg). Models were internally loaded with IOP using a fluid cavity, then externally with air-puff loading simulated using a turbulent computational fluid dynamics model. Corneal dynamic response parameters were extracted and used in development of two algorithms for IOP and corneal material behavior; fIOP and fSSI, respectively. The two algorithms were validated against clinical corneal dynamic response parameters for 476 healthy participants. The predictions of IOP and corneal material behavior were tested on how they varied with CCT, R, and age. Results: The present study produced a biomechanically corrected estimation of intraocular pressure (fIOP) and a corneal material stiffness parameter or Stress-Strain Index (fSSI), both of which showed no significant correlation with R (p > 0.05) and CCT (p > 0.05). Further, fIOP had no significant correlation with age (p > 0.05), while fSSI was significantly correlated with age (p = 0.001), which was found earlier to be strongly correlated with material stiffness. Conclusion: The present study introduced two novel algorithms for estimating IOP and biomechanical material behavior of healthy corneas in-vivo. Consideration of the fluid structure interaction between the cornea and the air puff of non-contact tonometry in developing these algorithms led to improvements in performance compared with bIOP and SSI. © Copyright © 2020 Maklad, Eliasy, Chen, Wang, Abass, Lopes, Theofilis and Elsheikh.

Keywords

AirBiomechanicsCentral corneal thicknessComputational fluid dynamicsComputational fluid dynamics modelingCorneaCorneal material behaviorDynamic responseFluid cavitiesFluid structure interactionFluid-structure interaction (fsi)Intra ocular pressureIntraocular pressureMaterial behaviorMaterial stiffnessMercury compoundsNovel algorithmNumerical methodsOcular biomechanicsParameter estimationResponse parametersStiffness

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Frontiers In Bioengineering And Biotechnology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 12/72, thus managing to position itself as a Q1 (Primer Cuartil), in the category Multidisciplinary Sciences.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 3.47, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-22, the following number of citations:

  • Scopus: 15

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-22:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 20.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 20 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.5.
  • The number of mentions on the social network X (formerly Twitter): 3 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: China; United Kingdom.