Mechanical properties of stromal striae, and their impact on corneal tissue behavior

Cornea is an essential element of our eye. The refractive power of the cornea is closely related to its shape, which depends on the balance between its mechanical properties and the intraocular pressure. However, in keratoconus, the shape of the cornea is altered, and the mechanical properties (i.e., elastic modulus and viscosity) are reduced. These alterations have been associated with the development of striae within the cornea. Recently, such striae have been observed in healthy corneas as well, but with slightly different shapes. Our study investigated the mechanical role of these striae. To this end, we performed an inflation test under Optical Coherence Tomography: tomographic volumes were acquired in the central zone of eleven human corneas during an inflation test. Striae planes were extracted from the segmented images, and principal deformation maps were obtained by Digital Volume Correlation (DVC). We observe that the pattern of the striae does not change with pressure, even far above physiological pressure. Maximum principal strains are co-localized with the striae and are oriented perpendicular to the striae. We also observe that principal deformations on the striae increase with depth in the cornea. Our results show that striae lead to greater deformability in the direction perpendicular to the striae, especially in the posterior part of the cornea where they are the most visible. This supports the idea that the striae are undulations in the cornea collagenous microstructure, which are progressively unfolded under loading. They decrease the global stiffness of the cornea, in particular in the posterior part, and thus may help in accommodating deformations.