The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Avetisov S.E.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Dzamikhova A.K.

Krasnov Research Institute of Eye Diseases

Shilova T.Yu.

OOO Tsentr mikrokhirurgii glaza — SMILE EYES Augenklinik Moskau

Akovantseva A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kotova S.L.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Frolova A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Efremov Yu.M.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kukanova V.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Timashev P.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kozlova I.V.

Krasnov Research Institute of Eye Diseases

Biomechanical properties of the corneal stroma extracted during the SMILE surgery in myopia with varying axial length

Authors:

Avetisov S.E., Dzamikhova A.K., Shilova T.Yu., Akovantseva A.A., Kotova S.L., Frolova A.A., Efremov Yu.M., Kukanova V.S., Timashev P.S., Kozlova I.V.

More about the authors

Journal: Russian Annals of Ophthalmology. 2025;141(6): 135‑144

DOI: 10.17116/oftalma2025141061135

Read: 391 times

Buy for 300₽
Contact the author
Table of contents

BIOMECHANICAL PROPERTIES OF THE CORNEAL STROMA EXTRACTED DURING THE SMILE SURGERY IN MYOPIA WITH VARYING AXIAL LENGTH
BIOMECHANICAL PROPERTIES OF THE CORNEAL STROMA EXTRACTED DURING THE SMILE SURGERY IN MYOPIA WITH VARYING AXIAL LENGTH

To cite this article:

Avetisov SE, Dzamikhova AK, Shilova TYu, et al. . Biomechanical properties of the corneal stroma extracted during the SMILE surgery in myopia with varying axial length. Russian Annals of Ophthalmology. 2025;141(6):135‑144. (In Russ.)
https://doi.org/10.17116/oftalma2025141061135

Подписка 2026 Вестник офтальмологии (Russian Annals of Ophthalmology)
МСФ на ЯМ
Использование инфографики авторами научных работ
Recommended articles:
Abstract:

One of the applied areas of biomechanics in ophthalmology involves studying changes in the fibrous coat of the eye in myopia. A series of studies using various methods has revealed alterations in the biomechanical properties of the sclera associated with progressive myopia due to structural and metabolic altering. However, corneal changes associated with myopia, and specifically those potentially influenced by the increase in axial length, remain less studied.

PURPOSE

To study the biomechanical properties of the corneal stroma removed during small-incision lenticule extraction (SMILE) in myopia with varying axial length (AL).

MATERIAL AND METHODS

The study included 122 lenticules (stromal corneal fragments) obtained from patients aged 17—47 years during SMILE refractive correction for myopia. The preoperative spherical equivalent ranged from –0.75 to –13.25 D, and the AL varied between 22.64 and 29.05 mm. Baseline central corneal thickness (CCT) was 493.00—622.00 μm (mean 560.64±25.62 μm). Measurements were performed using a Bruker Bioscope Resolve atomic force microscope (Bruker, USA).

RESULTS

Selective assessment of the Young’s modulus (Y) for the anterior and posterior lenticule surfaces revealed comparable values (medians 51.00 and 53.60 kPa; minimum—maximum range 5.20—222.00 and 7.30—214.30 kPa, respectively). Analysis of the relationship between Y values and axial length showed a statistically significant but weak positive correlation for the anterior surface, in contrast to the posterior surface. A statistically significant inverse correlation was observed between Y and CCT: weak for the anterior surface and moderate for the posterior surface.

CONCLUSION

Corneal fragments obtained during SMILE myopia correction provide a valuable model for biomechanical testing of the corneal stroma under conditions closely resembling in vivo physiology. The Young’s modulus values for the anterior and posterior lenticule surfaces were comparable and significantly correlated. The weak correlation between lenticule stiffness and axial length indirectly suggests minimal corneal biomechanical alterations associated with fibrous coat enlargement. The potential relationship between CCT and stromal biomechanics requires further investigation.

Keywords:

myopia
axial length
corneal stroma
SMILE procedure
atomic force microscopy
biomechanical properties

Authors:

Avetisov S.E.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Dzamikhova A.K.

Krasnov Research Institute of Eye Diseases

Shilova T.Yu.

OOO Tsentr mikrokhirurgii glaza — SMILE EYES Augenklinik Moskau

Akovantseva A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kotova S.L.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Frolova A.A.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Efremov Yu.M.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kukanova V.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Timashev P.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Kozlova I.V.

Krasnov Research Institute of Eye Diseases

Received:

03.07.2025

Accepted:

08.09.2025

Close metadata

References:

  1. Avetisov SE, Mamikonian VR, Trufanov SV, Osipian GA. Selective principle of modern approaches in keratoplasty. Russian Annals of Ophthalmology=Vestnik oftal’mologii. 2013;129(5):97-103. (In Russ.).
  2. Iomdina EN. Biomekhanicheskie i biokhimicheskie narusheniya sklery pri progressiruyushchei blizorukosti i metody ikh korrektsii [Biomechanical and biochemical disorders of the sclera in progressive myopia and methods of their correction]. In: Avetisov SE, Kashchenko TP, Shamshinova AM, eds. Zritel’nyye funktsii i ikh korrektsiya u detey [Visual functions and their correction in children]. Moscow: Meditsina; 2005. P. 163-183. (In Russ.).
  3. Sinha RA, Dupps WJ, Roberts CJ. Comparison of biomechanical effects of small-incision lenticule extraction and laser in situ keratomileusis: Finite-element analysis. J Cataract Refract Surg. 2014;40(6):971-980.  https://doi.org/10.1016/j.jcrs.2013.08.065
  4. Reinstein DZ, Archer TJ, Randleman JB. Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction. J Refract Surg. 2013;29(7):454-460.  https://doi.org/10.3928/1081597X-20130617-03
  5. Avetisov SE, Bubnova IA, Antonov AA. Clinical and experimental aspects of investigation of biomechanical properties of corneoscleral shell. Russian Annals of Ophthalmology=Vestnik oftal’mologii. 2013;129(5):83-91. (In Russ.).
  6. Avetisov SE, Osipyan GA, Abukerimova AK, Akovantseva AA, Efremov YuM, Frolova AA, Kotova SL, Timashev PS. Experimental studies of the biomechanical properties of the cornea. Russian Annals of Ophthalmology=Vestnik oftal’mologii. 2022;138(3):124-131. (In Russ.). https://doi.org/10.17116/oftalma2022138031124
  7. Shen M, Fan F, Xue A, Wang J, Zhou X, Lu F. Biomechanical properties of the cornea in high myopia. Vision Res. 2008;48(21):2167-2171. https://doi.org/10.1016/j.visres.2008.06.020
  8. Kotecha A, Elsheikh A, Roberts CR, Zhu H, Garway-Heath DF. Corneal thickness- and age-related biomechanical properties of the cornea measured with the ocular response analyzer. Invest Ophthalmol Vis Sci. 2006;47(12): 5337-5347. https://doi.org/10.1167/iovs.06-0557
  9. Liu J, Roberts CJ. Influence of corneal biomechanical properties on intraocular pressure measurement: quantitative analysis. J Cataract Refract Surg. 2005;31(1):146-155.  https://doi.org/10.1016/j.jcrs.2004.09.031
  10. Antonuk VD, Kuznetsova TS. Investigation of corneal biomechanical properties using the CORVIS ST device (Oculus, Germany) in patients with myopia and myopic astigmatism. Ophthalmosurgery=Oftal’mokhirurgiya. 2020; 4:20-28. (In Russ.). https://doi.org/10.25276/0235-4160-2020-4-20-28
  11. Vinciguerra R, Ambrósio R Jr, Elsheikh A, Roberts CJ, Lopes B, Morenghi E, Azzolini C, Vinciguerra P. Detection of Keratoconus with a New Biomechanical Index. J Refract Surg. 2016;32(12):803-810.  https://doi.org/10.3928/1081597X-20160629-01
  12. Avetisov KS, Bakhchieva NA, Avetisov SE, Novikov IA, Frolova AA, Akovantseva AA, Efremov YuM, Kotova SL, Timashev PS. Biomechanical properties of the lens capsule: A review. J Mech Behav Biomed Mater. 2020;103: 103600. https://doi.org/10.1016/j.jmbbm.2019.103600
  13. Efremov YuM, Bakhchieva NA, Shavkuta BS, Frolova AA, Kotova SL, Novikov IA, Akovantseva AA, Avetisov KS, Avetisov SE, Timashev PS. Mechanical properties of anterior lens capsule assessed with AFM and nanoindenter in relation to human aging, pseudoexfoliation syndrome, and trypan blue staining. J Mech Behav Biomed Mater. 2020;112:104081. https://doi.org/10.1016/j.jmbbm.2020.104081
  14. Avetisov KS, Bakhchieva NA, Avetisov SE, Novikov IA, Shitikova AV, Frolova AA, Timashev PS. Assessment of age-related changes in lens capsule biomechanics using atomic force microscopy. Russian Annals of Ophthalmology=Vestnik oftal’mologii. 2021;137(1):28-34. (In Russ.). https://doi.org/10.17116/oftalma202113701128
  15. Liu T, Shen M, Huang L, Xiang Y, Li H, Zhang Y, Wang Y. Characterization of hyperelastic mechanical properties for youth corneal anterior central stroma based on collagen fibril crimping constitutive model. J Mech Behav Biomed Mater. 2020;103:103575. https://doi.org/10.1016/j.jmbbm.2019.103575
  16. Xue C, Xiang Y, Shen M, Wu D, Wang Y. Preliminary Investigation of the Mechanical Anisotropy of the Normal Human Corneal Stroma. J Ophthalmol. 2018;2018:5392041. https://doi.org/10.1155/2018/5392041
  17. Xiang Y, Shen M, Xue C, Wu D, Wang Y. Tensile biomechanical properties and constitutive parameters of human corneal stroma extracted by SMILE procedure. J Mech Behav Biomed Mater. 2018;85:102-108.  https://doi.org/10.1016/j.jmbbm.2018.05.042
  18. Hoeltzel DA, Altman P, Buzard K, Choe KI. Strip extensiometry for comparison of the mechanical response of bovine, rabbit, and human corneas. J Biomech Eng. 1992;114(2):202-215.  https://doi.org/10.1115/1.2891373
  19. Avetisov SE, Mamikonyan VR. Keratorefrakcionnaja hirurgija [Keratorefractive surgery]. Moscow: Poligran; 1993. 120 p. (In Russ.).
  20. Avetisov SE, Mamikonyan VR, Zavalishin NN, Nenyukov AK. Experimental study of mechanical properties of the cornea and sclera adjacent areas. Ophthalmologic Journal=Ophthal’mologicheskii Zhurnal. 1988;(4):233-237. (In Russ.).
  21. Elsheikh A, Wang DF, Pye D. Determination of the modulus of elasticity of the human cornea. J Refract Surg. 2007;23(8):808-818.  https://doi.org/10.3928/1081-597X-20071001-11
  22. Anderson K, El-Sheikh A, Newson T. Application of structural analysis to the mechanical behavior of the cornea. J R Soc Lond Interface. 2004;1(1):3-15.  https://doi.org/10.1098/rsif.2004.0002
  23. Lavanya Devi AL, Nongthomba U, Bobji MS. Quantitative characterization of adhesion and stiffness of corneal lens of Drosophila melanogaster using atomic force microscopy. J Mech Behav Biomed Mater. 2016;53:161-173.  https://doi.org/10.1016/j.jmbbm.2015.08.015
  24. Lombardo M, Lombardo G, Carbone G, De Santo MP, Barberi R, Serrao S. Biomechanics of the anterior human corneal tissue investigated with Atomic Force Microscopy. Invest Ophthalmol Vis Sci. 2012;53(2):1050-1057. https://doi.org/10.1167/iovs.11-8720
  25. Weber IP, Rana M, Thomas PB, Dimov IB, Franze K, Madhavan RS. Effect of vital dyes on human corneal endothelium and elasticity of Descemet’s membrane. PLoS One. 2017;12(9):e0184375. https://doi.org/10.1371/journal.pone.0184375
  26. Candiello J, Cole GJ, Halfter W. Age-dependent changes in the structure, composition and biophysical properties of a human basement membrane. Matrix Biol. 2010;29(5):402-410.  https://doi.org/10.1016/j.matbio.2010.03.004
  27. Halfter W, Oertle P, Monnier CA, Camenzind L, Reyes-Lua M, Hu H, Candiello J, Labilloy A, Balasubramani M, Henrich PB, Plodinec M. New concepts in basement membrane biology. FEBS J. 2015;282(23):4466-4479. https://doi.org/10.1111/febs.13495
  28. McBrien NA, Gentle A. Role of the sclera in the development and pathological complications of myopia. Prog Retin Eye Res. 2003;22(3):307-338.  https://doi.org/10.1016/s1350-9462(02)00063-0
  29. Avetisov ES. Nekotorye itogi izucheniya etiologii i geneza miopii v institute glaznykh boleznei im. Gel’mgol’tsa [Some results of the study of etiology and genesis of myopia at the Helmholtz Eye Institute]. In: Materialy nauchnoi konferentsii po voprosam profilaktiki, patogeneza i lechenii zabolevanii organa zreniya u detei [Materials of the scientific conference on prevention, pathogenesis and treatment of diseases of the visual organ in children]. Moscow: 1971. P. 53-59. (In Russ).
  30. Iomdina E.N., Bauer S.M., Kotlyar K.E. Biomekhanika glaza: teoreticheskie aspekty i klinicheskie prilozheniya [Biomechanics of the eye: theoretical aspects and clinical applications]. Neroev VV, ed. Moscow: Real Taim; 2015. 208 p. (In Russ.).
  31. Shen M, Fan F, Xue A, Wang J, Zhou X, Lu F. Biomechanical properties of the cornea in high myopia. Vision Res. 2008;48(21):2167-2171. https://doi.org/10.1016/j.visres.2008.06.020
  32. Altan C, Demirel B, Azman E, Satana B, Bozkurt E, Demirok A, Yilmaz OF. Biomechanical properties of axially myopic cornea. Eur J Ophthalmol. 2012;22 Suppl 7:S24-28.  https://doi.org/10.5301/ejo.5000010
  33. Öner V, Taş M, Özkaya E, Oruç Y. Effect of pathological myopia on biomechanical properties: a study by ocular response analyzer. Int J Ophthalmol. 2015;8(2):365-368.  https://doi.org/10.3980/J.ISSN.2222-3959.2015.02.27
  34. Lu LL, Hu XJ, Yang Y, Xu S, Yang SY, Zhang CY, Zhao QY. Correlation of myopia onset and progression with corneal biomechanical parameters in children. World J Clin Cases. 2022;10(5):1548-1556. https://doi.org/10.12998/wjcc.v10.i5.1548
  35. He M, Wang W, Ding H, Zhong X. Corneal Biomechanical Properties in High Myopia Measured by Dynamic Scheimpflug Imaging Technology. Optom Vis Sci. 2017;94(12):1074-1080. https://doi.org/10.1097/OPX.0000000000001152
  36. Yu AY, Shao H, Pan A, Wang Q, Huang Z, Song B, McAlinden C, Huang J, Chen S. Corneal biomechanical properties in myopic eyes evaluated via Scheimpflug imaging. BMC Ophthalmol. 2020;20(1):279.  https://doi.org/10.1186/s12886-020-01530-w
  37. Solodkova EG, Balalin SV, Fokin VP, Lobanov EV. Assessment of the dependence of biomechanical properties of the cornea on topometric and biometric indicators. Modern problems of science and education=Sovremennye problemy nauki i obrazovaniya. 2021;3:153. (In Russ.). https://doi.org/10.17513/spno.30895
  38. Han F, Li M, Wei P, Ma J, Jhanji V, Wang Y. Effect of biomechanical properties on myopia: a study of new corneal biomechanical parameters. BMC Ophthalmol. 2020;20(1):459.  https://doi.org/10.1186/s12886-020-01729-x
  39. Dias JM, Ziebarth NM. Anterior and posterior corneal stroma elasticity assessed using nanoindentation. Exp Eye Res. 2013;115:41-46.  https://doi.org/10.1016/j.exer.2013.06.004
  40. Scarcelli G, Yun SH. In vivo Brillouin optical microscopy of the human eye. Opt Express. 2012;20(8):9197-9202. https://doi.org/10.1364/OE.20.009197
  41. Winkler M, Chai D, Kriling S, Nien CJ, Brown DJ, Jester B, Juhasz T, Jester JV. Nonlinear optical macroscopic assessment of 3-D corneal collagen organization and axial biomechanics. Invest Ophthalmol Vis Sci. 2011; 52(12): 8818-8827. https://doi.org/10.1167/iovs.11-8070
  42. Ruberti JW, Sinha Roy A, Roberts CJ. Corneal biomechanics and biomaterials. Annu Rev Biomed Eng. 2011;13:269-295.  https://doi.org/10.1146/annurev-bioeng-070909-105243
  43. Meek KM, Knupp C. Corneal structure and transparency. Prog Retin Eye Res. 2015;49:1-16.  https://doi.org/10.1016/j.preteyeres.2015.07.001
  44. Avetisov SE, Dzamikhova AK, Avetisov KS, Kobzeva AV, Abukerimova SK. Biomechanical control of myopia: potential of bidirectional corneal applanation with high-speed video recording. Russian Annals of Ophthalmology=Vestnik oftal’mologii. 2024;140(5):25-32. (In Russ.). https://doi.org/10.17116/oftalma202414005125
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.