A comprehensive study of corneal tissue responses to customized surgical treatments

Laser refractive surgery is a safe procedure that helps to get rid of corrective glasses and contact lenses. Refractive surgery removes tissue and reshapes cornea to improve vision, but it weakens the cornea in this process. If the weakness goes beyond a certain point it will lead to a complication resulting in corneal bulging and declining vision called ectasia. This complication is significant as surgery volume is predicted to increase to 5.8 million despite the pandemic (report by Eyewire News on 19/01/2021). This PhD thesis demostrates a predictive simulation with artificial intelligence to improve the safety of laser refractive surgery by understanding the strength of the cornea called AcuSimX. This software tool helps predict the corneal strength after surgery in advance, thus helping to avoid ectasia. It also helps in planning the treatment (customized corneal crosslinking) of a pre-existing bulge in the cornea (keratoconus). Similar tools are not common in medicine but are heavily used in other fields, e.g. space exploration. In case of a spacewalk at the international space station, the whole process is choreographed virtually on computers. Similarly, the thesis developed a unique tool that could help the surgeon plan and refine the surgery, thus customizing surgery to a specific patient.