A personalized simulation framework for optimizing orthokeratology lens parameters based on 3D corneal modeling and biomechanical analysis.

The aim of this study was to develop a patient-specific finite element model (FEM) to elucidate the biomechanical mechanisms governing orthokeratology (OK) lens design in real ocular conditions. Based on clinical corneal topography data, a patient-specific FEM was developed to incorporate asymmetric anatomical features. This model integrated an improved Iterative Closest Point (ICP) algorithm and a non-uniform squeeze-film pressure field. Simulation results were then compared with clinical measurements across multiple dimensions to evaluate predictive accuracy. The simulation framework demonstrated high predictive fidelity, The average Structure Similarity Index ( S S I M ) was 0.73, and the average Pearson correlation coefficient ( P C C ) reached 0.85. Treatment zone metrics: ( T Z radius accuracy = 93.7 % , Mean Absolute Error, M A E = 0.14   m m ); ( T Z S accuracy = 88.8 % , M A E = 1.73   m m 2 ). The maximum dioptric change ( D max accuracy = 79.0 % , M A E = 0.57 D ) Statistical analysis was performed to evaluate the effects of two Back Optic Zone Diameters (BOZD) and two Targeted Dioptric Reductions (TDR) on biomechanical outcomes. A personalized FEM for the biomechanical analysis of OK was successfully developed, providing biomechanical theoretical support for the optimization of customized lens parameters.