Departamento de Oftalmología, Hospital Universitario Clínico San Carlos, Instituto de Investigación sanitaria San Carlos, Madrid (Spain).
Centro Internacional de Oftalmología Avanzada, Madrid (Spain).
PLoS One. 2018 Aug 13;13(8):e0202128. doi: 10.1371/journal.pone.0202128. eCollection 2018.
To compare aqueous humour (AH) dynamics in the presence of a precrystalline (Implantable Collamer Lens®; ICL) or iris-fixed (Artiflex®) phakic intraocular lens (PIOL).
By computational fluid dynamics simulation, AH flow was modelled through a peripheral iridotomy (PI) or central lens hole (both 360 μm) in the presence of an Artiflex or ICL lens, respectively. The impacts of AH flow were then determined in terms of wall shear stress (WSS) produced on the endothelium or crystalline lens. Effects were also modelled for different scenarios of pupil diameter (PD 3.5 or 5.5 mm), ICL vault (100, 350, 800 μm) and number of Artiflex iridotomies (1 or 2) and location (12 or 6 o'clock).
For a PD of 3.5 mm, AH volumes flowing from the posterior to the anterior chamber were 37.6% of total flow through the lens hole (ICL) and 84.2% through PI (Artiflex). For an enlarged PD (5.5 mm), corresponding values were 10.3% and 81.9% respectively, so PI constitutes a very efficient way of evacuating AH. Central endothelial WSS in Pa was lower for the large vault ICL and the Artiflex (1-03 and 1.1-03 respectively) compared to the PIOL-free eye (1.6-03). Crystalline lens WSS was highest for the lowest vault ICL (1-04).
AH flow varied according to the presence of a precrystalline or iris-fixed intraocular lens. Endothelial WSS was lower for an implanted ICL with large vault and Artiflex than in the PIOL-free eye, while highest crystalline WSS was recorded for the lowest vault ICL.
比较存在前晶体（可植入 Collamer 透镜；ICL）或虹膜固定（Artiflex®）有晶状体眼人工晶状体（PIOL）时房水（AH）动力学。
通过计算流体动力学模拟，通过周边虹膜切开术（PI）或中央晶状体孔（均为 360 μm）模拟存在 Artiflex 或 ICL 镜片时的 AH 流动。然后根据内皮或晶状体上产生的壁切应力（WSS）来确定 AH 流动的影响。还针对不同的瞳孔直径（PD 3.5 或 5.5 mm）、ICL 拱顶（100、350、800 μm）和 Artiflex 虹膜切开术数量（1 或 2）和位置（12 或 6 点）的情况对效果进行了建模。
对于 PD 为 3.5 mm，从前房向后房流动的 AH 体积占通过晶状体孔（ICL）的总流量的 37.6％，通过 PI（Artiflex）的流量为 84.2％。对于扩大的 PD（5.5 mm），相应的值分别为 10.3％和 81.9％，因此 PI 是一种非常有效的 AH 排出方式。与无 PIOL 眼（1.6-03）相比，大拱顶 ICL 和 Artiflex 的中央内皮 WSS 较低，分别为 1-03 和 1.1-03。晶状体 WSS 最低的 ICL 为 1-04。
AH 流量根据存在前晶体或虹膜固定型人工晶状体而变化。具有大拱顶和 Artiflex 的植入式 ICL 的内皮 WSS 低于无 PIOL 眼，而最低拱顶 ICL 的晶状体 WSS 最高。
