title: Phakic iris-fixated intraocular lens placement in the anterior chamber: effects on aqueous flow.
abstract: OBJECTIVE
  Phakic intraocular lenses (pIOLs) are used for correcting vision; in this paper we investigate the fluid dynamical effects of an iris-fixated lens in the anterior chamber. In particular, we focus on changes in the wall shear stress (WSS) on the cornea and iris, which could be responsible for endothelial and pigment cell loss, respectively, and also on the possible increase of the intraocular pressure, which is known to correlate with the incidence of secondary glaucoma.
  
  
  METHODS
  We use a mathematical model to study fluid flow in the anterior chamber in the presence of a pIOL. The governing equations are solved numerically using the open source software OpenFOAM. We use an idealized standard geometry for the anterior chamber and a realistic geometric description of the pIOL.
  
  
  RESULTS
  We consider separately the main mechanisms that produce fluid flow in the anterior chamber. The numerical simulations allow us to obtain a detailed description of the velocity and pressure distribution in the anterior chamber, and indicated that implantation of the pIOL significantly modifies the fluid dynamics in the anterior chamber. However, lens implantation has negligible influence on the intraocular pressure and does not produce a significant increase of the shear stress on the cornea, while the shear stress on the iris, although increased, is not enough to cause detachment of cells.
  
  
  CONCLUSIONS
  We conclude that alterations in the fluid dynamics in the anterior chamber as a result of lens implantation are unlikely to be the cause of medical complications associated with its use.
authors.affiliation: Department of Civil Chemical and Environmental Engineering, University of Genoa, Genoa, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Repetto
authors.affiliation: Department of Civil Chemical and Environmental Engineering, University of Genoa, Genoa, Italy.
authors.forename: Jan O
authors.initials: JO
authors.lastname: Pralits
authors.affiliation: Department of Bioengineering, Imperial College London, London, United Kingdom.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Siggers
authors.affiliation: Ophtec BV, Groningen, The Netherlands.
authors.forename: Paolo
authors.initials: P
authors.lastname: Soleri
mesh_terms: D000867:Anterior Chamber / Q000502:physiology / Q000601:surgery; D001082:Aqueous Humor / Q000502:physiology*; D005901:Glaucoma / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008962:Models, Theoretical; D054120:Phakic Intraocular Lenses