A Mathematical Model of Corneal Metabolism in the Presence of an Iris-Fixated Phakic Intraocular Lens

Purpose: Corneal endothelial cell loss is one of the possible complications associated with phakic iris-fixated intraocular lens (PIOL) implantation. We postulate that this might be connected to the alteration of corneal metabolism secondary to the lens implantation. Methods: A mathematical model of transport and consumption/production of metabolic species in the cornea is proposed, coupled with a model of aqueous flow and transport of metabolic species in the anterior chamber. Results: Results are presented both for open and closed eyelids. We showed that, in the presence of a PIOL, glucose availability at the corneal endothelium decreases significantly during sleeping. Conclusions: Implantation of a PIOL significantly affects nutrient transport processes to the corneal endothelium especially during sleep. It must still be verified whether this finding has a clinical relevance.