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白内障手术连续环形撕囊有限元仿真分析

Finite element simulation analysis of continuous circular capsulorhexis in cataract surgery

作者: 韩少峰,李志朝,卢铭锋,裴雅静,杨洋,马科 
单位:1 华北电力大学能源动力与机械工程学院(北京102206)2 北京同仁医院(北京 100062)3 山西医科大学(太原 030072)4 北京航空航天大学机械工程及自动化学院(北京 100191)
关键词: 连续环形撕囊;有限元模型;前囊膜;撕囊力;力学行为 
分类号:
出版年·卷·期(页码):2025·44·1(9-15)
摘要:

目的 应用有限元分析(finite element analysis,FEA)实现人眼晶状体连续环形撕囊(continuous curvilinear capsulorhexis, CCC)操作,探讨在撕囊过程中的操作力和囊膜变形情况,以期实现撕囊的精准操作。方法 首先基于已有的晶状体临床物理和形态数据,构建连续环形撕囊有限元仿真模型,采用畸变能失效准则和黏聚力模型破坏准则分别模拟前囊膜自身和层间相邻组织的损伤,然后建立球坐标系描述撕囊运动参数,分析撕囊过程中组织的力学行为,获取撕囊力曲线。结果 当撕囊角度1=90°,2=30°时,最大撕囊力和平均撕囊力分别为19.22 mN和11.74 mN,仿真数据与文献中所述实验数据吻合较好;速度大小对平均撕囊力的影响为先增大后减小,并且随着失效应力的增加,平均撕囊力逐渐增加。整个撕囊过程能够很好地反映撕囊力和囊膜的变形情况,5步平均撕囊力分别为11.74 mN,9.70 mN,12.44 mN,11.01 mN和9.75 mN。结论 在撕囊过程中,囊膜与皮质之间首先发生破坏,随后才开始前囊膜自身的断裂,撕囊力主要由前囊膜裂纹扩展造成,且速度导致平均撕囊力先增大后减小,同时,失效应力的增大也会引起撕囊力的增大。对于整个撕囊过程,每一次倒手后的撕囊力能够保持稳定。本文所构建的撕囊有限元模型能够模拟连续环形撕囊操作。

Objective In order to achieve precise operation of continuous circular capsulorhexis (CCC), the finite element analysis (FEA) is used to explore the tear force and anterior capsule deformation during CCC. Methods Firstly, based on the existing clinical physical and morphological data of the lens, a model of continuous circular capsulorhexis was constructed. The damage of the anterior capsule itself and the adjacent tissue between capsule and cortex were simulated by using the distortion energy failure criterion and cohesive model failure criterion, respectively. Then, by constructing a spherical coordinate system to describe the parameters of tearing, the mechanical behavior of tissue was analyzed, and tear force curve was obtained. Results When the capsulorhexis angle 1=90°, 2=30°, the maximum and mean tear force were 19.22 mN and 11.74 mN, respectively. The capsulorhexis force is in good agreement with the experimental data described in literature. The effect of velocity on the mean tearing force is first increased and then decreased, and with the increase of failure stress, the mean tearing force gradually increased. The whole process of capsulorhexis can well reflect the tear force and the deformation of the capsule, and the average force of five tearing steps were 11.74 mN,9.70mN,12.44mN,11.01mN and 9.75mN, respectively. Conclusions In the process of capsulorhexis, the capsule and the cortex are destroyed first, and then the anterior capsule itself is broken. The tear force is mainly caused by the crack propagation of the anterior capsule, and the speed leads to the average tear force first increases and then decreases. At the same time, the increase of failure stress will also cause the increase of tear force. For the entire capsulorhexis process, the tear force after each reversal can remain stable. The finite element model constructed in our paper can simulate the CCC operation.

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