Sectorial customized corneal crosslinking for keratoconus: an inverse biomechanical design study with an anisotropic reduced shell finite-element surrogate

We propose an inverse biomechanical design framework for sectorial customized corneal crosslinking in keratoconus. The cornea is modeled as an anisotropic reduced shell with spatially varying crosslinking-induced stiffening, enabling the optimization of localized treatment patterns rather than uniform irradiation profiles. Numerical simulations show that sectorial stiffening can redistribute curvature, reduce localized steepening, and improve corneal regularity in decentered keratoconus models while preserving biomechanical plausibility. These results support the use of patient-specific computational planning for customized crosslinking protocols and provide a basis for future integration with corneal tomography and programmable ultraviolet delivery systems.