Corneal stromal dehydration and optimal stromal exposure time during corneal refractive surgery measured using a...

To quantitatively analyze human corneal stromal dehydration and estimate proper corneal stromal exposure time during corneal refractive surgery.

The central thickness changes over time in 34 pieces of human corneal tissue were measured using a white light interferometer. The corneal stromal tissue was obtained by femtosecond laser small incision lenticule extraction. The thickness-time dehydration fitting curves were drawn, and the determination coefficient R² was calculated. The differences in the fitting curve equation coefficients were compared between the thin and thick lenticule groups. The optimal stromal exposure time was calculated under various conditions, including different optical zones and allowable refractive errors.

A water loss variation model was successfully established. Linear and quadratic fitting curves were drawn, and the determination coefficient R² values were significantly close to 1. The average values of R² for quadratic curves and linear phases 1, 2, and 3 were 0.998 ± 0.002, 0.995 ± 0.007, 0.996 ± 0.003, and 0.984 ± 0.035, respectively. The optimal stromal exposure time varied under different optical zones and allowable diopter error conditions. Taking the allowable error of 0.50 D and the optical zone size of 6.5 mm as an example, the optimal time was approximately 24 s.

The dehydration rate of the human corneal stroma is nonlinear, and the quadratic stromal thickness-time dehydration fitting curve is more in line with the actual water loss trend. The length of the stroma exposure time may affect the postoperative refractive accuracy after corneal refractive surgery.