Aqueous flow in the presence of a perforated iris-fixated intraocular lens

The aim of this study is to investigate the characteristics of the aqueous humour flow in the anterior chamber of the eye in the presence of a perforated, phakic, iris-fixated intraocular lens (pIOL). Such pIOLs are implanted in the anterior chamber in front of the iris and therefore they interfere with aqueous motion. The aim of this work is to investigate whether a perforation in the body of the pIOL can improve its fluid dynamics performance. Numerical simulations are conducted using the free computational fluid dynamics program OpenFOAM. The aqueous humour is modelled as a Newtonian incompressible fluid and, when temperature effects are considered, the Navier-Stokes equations are coupled to the energy equation, using Boussinesq's approach to account for fluid density changes associated temperature variations. The pressure drop across the anterior chamber is calculated considering perforations in the pIOL of various sizes and also studying the extreme case in which the passage between the iris and the pIOL gets plugged, thus leaving the hole in the pIOL as the only possible pathway for aqueous flow. The study shows that the presence of a hole in the pIOL can only have a significant role on the pressure in the eye if the normal aqueous flow in the region between the pIOL and the iris gets blocked and has a negligible effect on the wall shear stress on the cornea.