{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:10:21Z","timestamp":1787026221108,"version":"build-2736575974"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      We developed and analytically evaluated a novel physical-mathematical model aimed at quantifying and minimizing the systematic error (\n                      <jats:italic>ERR<\/jats:italic>\n                      ) between true intraocular pressure (\n                      <jats:italic>IOPT<\/jats:italic>\n                      ) and that measured by Goldmann applanation tonometry (\n                      <jats:italic>IOPG<\/jats:italic>\n                      ), by incorporating patient-specific corneal biomechanical properties.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We constructed a model based on physical force balance, simulating the applanation of the cornea as a deformable elastic shell influenced by intraocular pressure and external forces. Four distinct forces were mathematically defined and computed: F1 \u2013 intraocular pressure acting on the posterior corneal surface;\n                      <jats:italic>F2<\/jats:italic>\n                      \u2013 elastic resistance of the corneal tissue to flattening;\n                      <jats:italic>F3<\/jats:italic>\n                      \u2013 adhesive force due to tear film surface tension;\n                      <jats:italic>F4<\/jats:italic>\n                      \u2013 the net force applied by the examiner and recorded by the\n                      <jats:italic>GAT<\/jats:italic>\n                      device. The model integrates key anatomical and biomechanical parameterscentral corneal thickness, mean apical curvature radius, and corneal elastic modulus\u2014to quantify\n                      <jats:italic>ERR<\/jats:italic>\n                      as a function of individual variability. These parameters are derived from two sequential applanation measurements (\n                      <jats:italic>IOPG<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>0<\/jats:italic>\n                      <\/jats:sub>\n                      <jats:italic>and IOPG<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>1<\/jats:italic>\n                      <\/jats:sub>\n                      ), acquired through a custom-designed dual-zone applanation prism.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Simulations demonstrated that\n                      <jats:italic>ERR<\/jats:italic>\n                      increases proportionally with central corneal thickness and elastic modulus, and decreases with increasing corneal curvature radius. For standard corneal values (thickness:\n                      <jats:italic>0.536 mm<\/jats:italic>\n                      ; curvature:\n                      <jats:italic>7.15 mm<\/jats:italic>\n                      ; elasticity:\n                      <jats:italic>0.16\u00a0MPa<\/jats:italic>\n                      ), the model closely approximates\n                      <jats:italic>IOPT<\/jats:italic>\n                      . Deviations from these reference values result in systematic over- or underestimation of\n                      <jats:italic>IOPG<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This analytical model provides a transparent, biomechanically grounded method for correcting\n                      <jats:italic>GAT<\/jats:italic>\n                      measurements and estimating true\n                      <jats:italic>IOP<\/jats:italic>\n                      with improved precision. It highlights the critical influence of patient-specific corneal properties and lays the foundation for personalized tonometry in clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fbioe.2026.1757214","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:06:27Z","timestamp":1777442787000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cA dual-applanation physical model to improve accuracy in goldmann tonometry by accounting for corneal biomechanics\u201d"],"prefix":"10.3389","volume":"14","author":[{"given":"Gaetano","family":"Barbaro","sequence":"first","affiliation":[{"name":"Istitute Refractive Ophthalmology Surgery Napoli","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Caruso","sequence":"additional","affiliation":[{"name":"Clinica Oculistica, Pellegrini Hospital, ASL Napoli 1","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Troisi","sequence":"additional","affiliation":[{"name":"UOC di Oculistica, Ruggi d\u2019Aragona Hospital","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Clinica Oculistica, Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"434","DOI":"10.3928\/1081597X-20170426-02","article-title":"Integration of scheimpflug-based corneal tomography and biomechanical assessments for enhancing ectasia detection","volume":"33","author":"Ambrosio","year":"2017","journal-title":"J. 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