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Brillouin microscopy for focal biomechanical measurements in normal and keratoconic corneas: A narrative review

Brillouin microscopy for focal biomechanical measurements in normal and keratoconic corneas: A narrative review

Bassel Hammoud ¹, Justin S Schumacher ², Hongyuan Zhang ¹, Barbara A L Dutra ³, Bianca N Susanna ⁴, Giuliano Scarcelli ², J Bradley Randleman ⁵

Bassel Hammoud ¹, Justin S Schumacher ², Hongyuan Zhang ¹

¹Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
²Fischell Department of Bioengineering, University of Maryland, College Park, Maryland, USA.
³Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil.
⁴Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil; Sorocaba Eye Hospital, Sorocaba, Brazil.
⁵Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA. Electronic address: randlej@ccf.org.

⁰Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Survey of Ophthalmology +

|

June 13, 2025

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View abstract on PubMed

Summary

This summary is machine-generated.

Brillouin microscopy can now measure corneal mechanics in vivo, detecting early keratoconus by identifying focal weakening. This technology promises to revolutionize diagnosis and treatment for this progressive eye condition.

Area Of Science

Ophthalmology
Biomedical Optics
Materials Science

Background

Corneal mechanical weakness is a key factor in keratoconus and refractive surgery complications.
Focal, rather than generalized, weakening is theorized to cause corneal decompensation.
Understanding early, subclinical disease manifestations is crucial for effective management.

Purpose Of The Study

To highlight the development of Brillouin microscopy for in vivo corneal mechanical analysis.
To explore advances and limitations in current imaging technologies.
To outline future directions for analyzing subclinical keratoconus.

Main Methods

Utilizing non-perturbative Brillouin microscopy to measure corneal mechanics via Brillouin light scattering.
Analyzing the corneal elastic modulus (longitudinal modulus).
Employing motion-tracking Brillouin imaging with optical coherence tomography and eye tracking for 3-D localization.

Main Results

Brillouin microscopy can detect axial anisotropy in normal corneas and focal weakening in keratoconic corneas.
Motion-tracking Brillouin imaging identified subclinical keratoconus by detecting locally reduced anterior corneal Brillouin shift values.
This method outperformed Scheimpflug technology in differentiating subclinical keratoconus from normal corneas.

Conclusions

In vivo Brillouin microscopy offers a novel approach for analyzing corneal mechanics.
The technology shows promise for early detection and diagnosis of subclinical keratoconus.
Further development can advance understanding of keratoconus progression and management.

Keywords:

Brillouin microscopy LASIK Youngs modulus corneal biomechanics corneal cross-linking keratoconus refractive surgery subclinical keratoconus

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