Moses R A
Am J Ophthalmol. 1981 Dec;92(6):804-10. doi: 10.1016/s0002-9394(14)75634-x.
The concept of the conventional aqueous outflow pathway (through the trabecular meshwork and other components of the canal's inner wall, along Schlemm's canal to collector channels, and out of the eye through the collector channels) was modeled on tubes with leaky walls and a network of electrical resistances. Analysis of these models suggested experiments to test the models and to assess the magnitude of the resistance of portions of the pathway. We found that the well-known increase in outflow resistance with increased intraocular pressure was, in large measure, the result of blockage of the collector channels, probably by the canal's inner wall. A model of the trabecular meshwork predicted that tension on the scleral spur and trabecular mesh would cause the meshwork to arch over Schlemm's canal. We depressed the lens to generate such tension, and found that the resistance of the inner wall of the canal decreased. In one eye, lens depression also decreased resistance to flow in the collector channels and the canal of Schlemm and prompted the suggestion that when secretory inhibitors are used in glaucoma, cyclo-tonic agents should be used simultaneously to relieve canal collapse and blockage of collector channels by inner canal wall.
传统的房水流出途径(通过小梁网和巩膜静脉窦内壁的其他成分,沿施莱姆管至集合管,并通过集合管流出眼外)的概念是基于具有渗漏壁的管道和电阻网络建立的模型。对这些模型的分析提出了一些实验,以测试模型并评估该途径各部分的阻力大小。我们发现,众所周知的随着眼内压升高流出阻力增加,在很大程度上是集合管阻塞的结果,可能是由巩膜静脉窦内壁导致的。小梁网模型预测,巩膜突和小梁上的张力会使小梁网在施莱姆管上方形成拱形。我们压低晶状体以产生这种张力,发现巩膜静脉窦内壁的阻力降低。在一只眼中,压低晶状体还降低了集合管和施莱姆管内的流动阻力,并促使人们提出,当在青光眼治疗中使用分泌抑制剂时,应同时使用睫状肌收缩剂以缓解巩膜静脉窦塌陷和集合管被内管壁阻塞的情况。