Author(s): Silver DM, Quigley HA
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Abstract PURPOSE: To explore the hypothesis that differential pressure between the anterior and posterior chambers arises from the dynamics of aqueous flow across the iris-lens channel. METHODS: Navier-Stokes equations of fluid dynamics were derived and evaluated numerically for a viscous homogeneous isotropic fluid (aqueous) passing through the iris-lens channel, which is a spherical disc-shaped region conforming to the lens curvature while maintaining a separation distance (channel height) over a certain disc width (channel length). The effect of iridotomy was assessed using Poiseuille flow dynamics. RESULTS: In the absence of measured values, ranges of anatomic and physiological variables were used for calculations. The magnitude of the posterior to anterior pressure difference was greater with increases in channel length or aqueous flow and with decreases in channel height or pupil diameter. With a nominal channel length of 0.5 mm, aqueous outflow of 2.2 microl/min, and pupil diameter of 1 mm, the pressure difference increased from 0.9 to 10 mm Hg when the channel height decreased from 7 to 3 microm. A channel height of 10 microm or greater reduced the pressure difference below 1 mm Hg for the full range of other channel parameters considered. A 50-microm iridotomy reduced the pressure difference below 1 mm Hg. CONCLUSIONS: The flow of aqueous through the iris-lens channel is driven by the pressure differential between the posterior and anterior chambers. Viscous forces within the aqueous govern the magnitudes of the flow resistance and the pressure differential. The geometry and dimensions of a specific iris-lens channel will determine whether the pressure differential is of clinical significance.
This article was published in J Glaucoma
and referenced in Journal of Clinical & Experimental Ophthalmology