A personalized simulation framework for optimizing orthokeratology lens parameters based on 3D corneal modeling and...

The aim of this study was to develop a patient-specific finite element model (FEM) to elucidate the biomechanical mechanisms governing orthokeratology (OK) lens design in real ocular conditions. Based on clinical corneal topography data, a patient-specific FEM was developed to incorporate asymmetric anatomical features. This model integrated an improved Iterative Closest Point (ICP) algorithm and a non-uniform squeeze-film pressure field. Simulation results were then compared with clinical measurements across multiple dimensions to evaluate predictive accuracy. The simulation framework demonstrated high predictive fidelity, The average Structure Similarity Index $\left(SSIM\right)$ was 0.73, and the average Pearson correlation coefficient $\left(PCC\right)$ reached 0.85. Treatment zone metrics: ( $T{Z}_{\mathrm{radius}}$ accuracy $=93.7\%$ , Mean Absolute Error, $MAE=0.14mm$ ); ( $T{Z}_S$ accuracy $=88.8\%$ , $MAE=1.73m{m}^2$ ). The maximum dioptric change ( $D_{\max }$ accuracy $=79.0\%$ , $MAE=0.57D$ ) Statistical analysis was performed to evaluate the effects of two Back Optic Zone Diameters (BOZD) and two Targeted Dioptric Reductions (TDR) on biomechanical outcomes. A personalized FEM for the biomechanical analysis of OK was successfully developed, providing biomechanical theoretical support for the optimization of customized lens parameters.