Simulation of fluid-structure interaction during the phaco-emulsification stage of cataract surgery

Wang, Z., Wang, C., Zhao, F., Qi, N., Lockington, D., Ramaesh, K., Stewart, P. S. , Luo, X. and Tang, H. (2022) Simulation of fluid-structure interaction during the phaco-emulsification stage of cataract surgery. International Journal of Mechanical Sciences, 214, 106931. (doi: 10.1016/j.ijmecsci.2021.106931)

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Abstract

During cataract surgery the clouded lens is broken up by phacoemulsification. The iris can become highly mobile and could be entrained by the phacoemulsification probe, under a condition known as intraoperative floppy iris syndrome (IFIS). In this study we explore the mechanism of IFIS during phacoemulsification-based cataract surgery using fluid-structure interaction (FSI) simulations. As the first study of its kind, we developed a simplified two-dimensional simulation framework and utilized it to elucidate the dynamics of the iris and surrounding aqueous humor during phaco-emulsification. Three types of iris dynamics were observed when the phaco probe was operated in the torsional vibration mode and placed at various locations in the anterior chamber, which we termed as the repulsion (where the iris is repelled by the probe), attraction (where the iris is drawn toward the probe) and adhesion mode (where the iris is adhered to the probe at some point along its length), respectively. The anterior chamber is partitioned into different zones which exhibit each of these three modes. Furthermore, the effects of iris stiffness and length as well as the power and frequency of the probe operation were investigated. It was found that IFIS could be mitigated by increasing the iris stiffness, shortening the iris length (i.e., pupil dilation), decreasing the power of the emulsification probe, and maintaining the probe operation frequency in a range around the frequency of the iris’ fundamental bending mode. This study provides new physical insights into the dynamics of fluid-iris interaction during phaco-emulsification, which may guide clinicians to optimise their surgical protocol.

Item Type:Articles
Additional Information:We gratefully acknowledge the financial support for this study from the Research Grants Council of Hong Kong under General Research Fund (Project No. 15249316). XYL also wishes to acknowledge the UK Engineering and Physical Sciences Research Council grants (EP/S020950/1, and EP/S030875/1). NQ is supported by the National Nature Science Foundation of China (No. 11902181) and the National Nature Science Foundation of Shandong Province (No. ZR2019QA014).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Luo, Professor Xiaoyu and Stewart, Dr Peter
Creator Roles:
Stewart, P. S.Investigation, Writing – review and editing
Luo, X.Investigation, Writing – review and editing
Authors: Wang, Z., Wang, C., Zhao, F., Qi, N., Lockington, D., Ramaesh, K., Stewart, P. S., Luo, X., and Tang, H.
College/School:College of Science and Engineering > School of Mathematics and Statistics > Mathematics
Journal Name:International Journal of Mechanical Sciences
Publisher:Elsevier
ISSN:0020-7403
ISSN (Online):1879-2162
Published Online:14 November 2021
Copyright Holders:Copyright © 2021 Elsevier Ltd
First Published:First published in International Journal of Mechanical Sciences 214: 106931
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
303231A whole-heart model of multiscale soft tissue mechanics and fluid structureinteraction for clinical applications (Whole-Heart-FSI)Xiaoyu LuoEngineering and Physical Sciences Research Council (EPSRC)EP/S020950/1M&S - Mathematics
303232EPSRC Centre for Multiscale soft tissue mechanics with MIT and POLIMI (SofTMech-MP)Xiaoyu LuoEngineering and Physical Sciences Research Council (EPSRC)EP/S030875/1M&S - Mathematics