Continuum versus micromechanical modeling of corneal biomechanics

Two alternative numerical models of the human cornea are used to simulate the mechanical response under the action of a physiological intraocular pressure (IOP). The first model is continuum or macromechanical, considering the stromal tissue as a bulk material with stochastic distribution of the spatial variability of reinforcing collagen fibers. The second model is discrete or micromechanical, considering the sole collagen-crosslink stiffening micro-structure. The geometry of the two models is reconstructed from corneal topographer images. Simulations consider the behavior of a healthy cornea and of a keratoconus cornea. For the keratoconus the material properties of a portion of the cornea are reduced to 1/8 of the values used for the healthy tissue. It is found that, for suitable choice of the material parameters for the discrete model, in the healthy case the mechanical responses of the two models are fully comparable. In the keratoconus case, both models capture with comparable accuracy the anterior shape of the conus; in addition, the discrete model is able to describe the tissue thinning typical of the pathology. Despite the inclusion of stochastic material properties, starting from a healthy condition, continuum models of the cornea are not able to predict the thinning of a keratoconus cornea, while the inclusion of the underlying collagen microstructure allows for a proper description of pathologic mechanical behaviors.