Understanding corneal biomechanical influence in intraocular pressure estimations using optical coherence elastography with a multi-excitation probe

This study investigated the influence of corneal biomechanics on intraocular pressure (IOP) estimation, particularly in normotensive glaucoma patients. Using Phase Sensitive Optical Coherence Tomography with air-puff and ultrasonic systems, we analyzed the correlation between corneal phase speed (Young's modulus), thickness, and controlled IOP (5-25 mmHg) with IOP-related parameters (apex velocity, applanation pressure, displacement) in eye phantoms. Strong correlations were found between phase speed and several IOP parameters (e.g., R = 0.914 for V2), indicating that corneal biomechanics significantly influence IOP estimations. Weaker, but still present, correlations existed between thickness and controlled IOP with these parameters. These findings highlight the importance of considering corneal biomechanics for accurate IOP assessment and glaucoma diagnosis.