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Jeffrey J. Heys, Victor H. Barocas; Computational Evaluation of the Role of Accommodation in Pigmentary Glaucoma. Invest. Ophthalmol. Vis. Sci. 2002;43(3):700-708.
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purpose. Accommodation has been proposed as the cause of the bowing of
the posterior iris that occurs in eyes with pigmentary dispersion
syndrome. A mathematical model of the anterior eye is needed to explore
the elastohydrodynamic effects of accommodation on both the aqueous
humor dynamics and the contour of the iris.
methods. A mathematical model of the coupled aqueous humor–iris system was used
to predict the effects of accommodation on the iris position and
pressure distribution in the aqueous humor.
results. The mathematical model predicts that accommodation produces a pressure
reversal—the anterior chamber pressure being higher than the posterior
chamber—and iris movement into a more concave configuration. Total
time for accommodation, iris modulus, iris attachment point, and
trabecular meshwork permeability all had little or no effect on the
iris contour and pressure change. The amount of accommodation, however,
had a dramatic effect on both the amount of iris curvature and
especially the pressure reversal. For accommodation resulting
in a 0.6-mm change in anterior chamber depth, the pressure in the
anterior chamber was more than 1.0 mm Hg higher than that in the
posterior chamber, compared with a pressure difference of less than 0.1
mm Hg for accommodation resulting in a 0.2-mm change in anterior
conclusions. The results confirm that accommodation produces bowing of the posterior
iris and the magnitude of the bowing is a strong function of the amount
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