The assessment of the underlying factors that influence the biomechanics and dynamics of the cornea is essential for preserving the safety and efficacy of refractive surgeries. In the present work, the operated cornea with intracorneal ring segments (ICRSs) in a patient-specific finite-element model (FEM) was subjected to the air-puff. Then, the dynamic deformation parameters predicted by the FEM were obtained and compared with the corresponding values in clinical measurements. In this study, the effects of ICRS design, position, and implementation procedure in six different surgical scenarios were examined on the induced corneal stresses, deformation behavior, and shape regularization. While surgical scenarios with arc lengths of 160° (single and double segment), 355° implemented with the tunnel incision method provided similar maximum apical displacement (MAD) and highest concavity radius of curvature HCR), they induced significantly different flattening effects. The surgical scenarios with the segment of 160° arc-length implemented in nasal–temporal direction showed an approximately 15% higher reduction in mean corneal power ($K_m$) value than the superior–inferior direction. From a solid-mechanics perspective, the study of ICRS mechanics in the cornea also confirmed the importance of the implementation position to achieve satisfactory flattening outcomes. Comparison of the two types of ICRS implementation procedures showed that, although the pocket method demonstrated a 10.23% higher MAD, it induced a higher reduction in the HCR of 21.65% compared with tunnel incision. The developed numerical model demonstrated the direct correlation of the ICRS insertion site with induced contact stresses and ICRS position stability. The study hypothesizes the significant influence of ICRS implementation position and procedure on the corneal biomechanical and dynamical behaviors. The proposed approach can be assessed as a robust and novel framework for planning optimized corneal refractive surgeries.

评估影响角膜生物力学和动力学的潜在因素对于保持屈光手术的安全性和有效性至关重要。在目前的工作中，患者特定有限元模型 (FEM) 中带有角膜内环段 (ICRS) 的手术角膜受到吹气。然后，获得由 FEM 预测的动态变形参数，并与临床测量中的相应值进行比较。在这项研究中，研究了 ICRS 设计、位置和实施程序在六种不同手术场景中对诱导角膜应力、变形行为和形状规则化的影响。而弧长为160°（单段和双段）的手术场景，使用隧道切口方法实施的 355° 提供了相似的最大根尖位移 (MAD) 和最高凹曲率半径 HCR)，它们导致显着不同的压扁效果。在鼻颞方向实施 160°弧长段的手术方案显示平均角膜屈光力降低约 15%。${钾}_{米}$) 值比上下方向。从固体力学的角度来看，ICRS在角膜中力学的研究也证实了实施位置对于获得满意的扁平化结果的重要性。两种类型的 ICRS 实施程序的比较表明，虽然口袋法的 MAD 高 10.23%，但与隧道切口相比，HCR 降低了 21.65%。开发的数值模型证明了 ICRS 插入部位与诱导接触应力和 ICRS 位置稳定性之间的直接相关性。该研究假设 ICRS 的实施位置和程序对角膜生物力学和动力学行为有显着影响。