Anterior and posterior axial lens displacement and human aqueous outflow facility

We studied the effect of anterior and posterior axial crystalline lens displacement (and thereby ciliary tone) on the aqueous humor outflow facility in enucleated human eyes. After attaching a reversible footplate plunger to the anterior lens capsule with cyanoacrylate, the lens was placed in one of three positions: "neutral baseline," posterior displacement (2.5 mm), or anterior displacement (2.0 mm). In seven pairs of eyes, the mean "neutral baseline" was not statistically different from the control eye, but anterior lens displacement decreased outflow facility "C" by 0.14 (36%) (P less than 0.0001), and posterior displacement increased "C" by 0.18 (50%) (P less than 0.01). Anterior or posterior lens displacement after complete ciliary body detachment produced no effect on outflow facility in two pairs. Histologic correlation studies demonstrated narrowing of the intertrabecular spaces and Schlemm's canal in the eyes fixed in anterior lens displacement, and widening of the same structures in the eyes fixed in posterior lens displacement. The lens-zonular-ciliotrabecular force vectors are responsible for the compression or decompression of the meshwork and Schlemm's canal in this model, with compression decreasing, and decompression increasing aqueous humor outflow facility.