Contribution of Different Anatomical and Physiologic Factors to Iris Contour and Anterior Chamber Angle Changes During Pupil Dilation: Theoretical Analysis

Citation: Jouzdani S, Amini R, Barocas VH. Contribution of different anatomical and physiologic factors to iris contour and anterior chamber angle changes during pupil dilation: theoretical analysis. Invest Ophthalmol Vis Sci. 2013;54:297754: -298454: . DOI:10. 1167 PURPOSE. To investigate the contribution of three anatomical and physiologic factors (dilator thickness, dynamic pupillary block, and iris compressibility) to changes in iris configuration and anterior chamber angle during pupil dilation. METHODS. A mathematical model of the anterior segment based on the average values of ocular dimensions was developed to simulate pupil dilation. To change the pupil diameter from 3.0 to 5.4 mm in 10 seconds, active dilator contraction was applied by imposing stress in the dilator region. Three sets of parameters were varied in the simulations: (1) a thin (4 lm, 1% of full thickness) versus a thick dilator (covering the full thickness iris) to quantify the effects of dilator anatomy, (2) in the presence (þPB) versus absence of pupillary block (ÀPB) to quantify the effect of dynamic motion of aqueous humor from the posterior to the anterior chamber, and (3) a compressible versus an incompressible iris to quantify the effects of iris volume change. Changes in the apparent iris-lens contact and angle open distance (AOD500) were calculated for each case. RESULTS. The thin case predicted a significant increase (average 700%) in iris curvature compared with the thick case (average 70%), showing that the anatomy of dilator plays an important role in iris deformation during dilation. In the presence of pupillary block (þPB), AOD500 decreased 25% and 36% for the compressible and incompressible iris, respectively. CONCLUSIONS. Iris bowing during dilation was driven primarily by posterior location of the dilator muscle and by dynamic pupillary block, but the effect of pupillary block was not as large as that of the dilator anatomy according to the quantified values of AOD500. Incompressibility of the iris, in contrast, had a relatively small effect on iris curvature but a large effect on AOD500; thus, we conclude that all three effects are important

SALS Instructions

This document lists the instructions for scanning a sample in the SALS System

Instructions for Scanning Biax Samples

This document details the instructions used for scanning the tricuspid valves that were used on the biax machine

Mechanical Response Changes in Porcine Tricuspid Valve Anterior Leaflet Under Osmotic-Induced Swelling

Since many soft tissues function in an isotonic in-vivo environment, it is expected that physiological osmolarity will be maintained when conducting experiments on these tissues ex-vivo. In this study, we aimed to examine how not adhering to such a practice may alter the mechanical response of the tricuspid valve (TV) anterior leaflet. Tissue specimens were immersed in deionized (DI) water prior to quantification of the stress–strain responses using an in-plane biaxial mechanical testing device. Following a two-hour immersion in DI water, the tissue thickness increased an average of 107.3% in the DI water group compared to only 6.8% in the control group, in which the tissue samples were submerged in an isotonic phosphate buffered saline solution for the same period of time. Tissue strains evaluated at 85 kPa revealed a significant reduction in the radial direction, from 34.8% to 20%, following immersion in DI water. However, no significant change was observed in the control group. Our study demonstrated the impact of a hypo-osmotic environment on the mechanical response of TV anterior leaflet. The imbalance in ions leads to water absorption in the valvular tissue that can alter its mechanical response. As such, in ex-vivo experiments for which the native mechanical response of the valves is important, using an isotonic buffer solution is essential

Dilation of tricuspid valve annulus immediately after rupture of chordae tendineae in ex-vivo porcine hearts.

PURPOSE:Chordae rupture is one of the main lesions observed in traumatic heart events that might lead to severe tricuspid valve (TV) regurgitation. TV regurgitation following chordae rupture is often well tolerated with few or no symptoms for most patients. However, early repair of the TV is of great importance, as it might prevent further exacerbation of the regurgitation due to remodeling responses. To understand how TV regurgitation develops following this acute event, we investigated the changes on TV geometry, mechanics, and function of ex-vivo porcine hearts following chordae rupture. METHODS:Sonomicrometry techniques were employed in an ex-vivo heart apparatus to identify how the annulus geometry alters throughout the cardiac cycle after chordae rupture, leading to the development of TV regurgitation. RESULTS:We observed that the TV annulus significantly dilated (~9% in area) immediately after chordae rupture. The annulus area and circumference ranged from 11.4 ± 2.8 to 13.3 ± 2.9 cm2 and from 12.5 ± 1.5 to 13.5 ± 1.3 cm, respectively, during the cardiac cycle for the intact heart. After chordae rupture, the annulus area and circumference were larger and ranged from 12.3 ± 3.0 to 14.4 ± 2.9 cm2 and from 13.0 ± 1.5 to 14.0 ± 1.2 cm, respectively. CONCLUSIONS:In our ex-vivo study, we showed for the first time that the TV annulus dilates immediately after chordae rupture. Consequently, secondary TV regurgitation may be developed because of such changes in the annulus geometry. In addition, the TV leaflet and the right ventricle myocardium are subjected to a different mechanical environment, potentially causing further negative remodeling responses and exacerbating the detrimental outcomes of chordae rupture