Acute Effects of Intraocular Pressure-Induced Changes in Schlemm's Canal Morphology on Outflow Facility in Healthy Human Eyes

PURPOSE. To estimate the outflow facility coefficient (C) as a function of Schlemm's canal cross-sectional area (SCAR) in healthy subjects using noninvasive oculopression tonometry (OPT). METHODS. In 25 healthy volunteers, intraocular pressure (IOP) decay values were recorded by a ophthalmodynamometer, with a fixed external force (0.15 N) on the inferior-temporal eyelid, every 10 seconds, for four minutes, and again after a 30-minute rest. Schlemm's canal profile images and IOP were obtained pre-procedurally (baseline), immediately (T0), and at 1-minute intervals post-procedurally (T1, T2, T3, and T4). C was calculated for different IOPs. The SCAR, coronal, and the meridional diameter of Schlemm's canal were calculated. RESULTS. Mean C-0 for the maximum IOP was 0.020 +/- 0.017 mu L/min/mm Hg; mean C was 0.018 +/- 0.0071 and 0.058 +/- 0.0146 mu L/min/mm Hg at 40 and 20 mm Hg, respectively. C was nonlinearly dependent on the IOP (R-2 = 0.945). The SCAR was 5440 +/- 3140.82, 3947.6 +/- 2246.8, and 5375.7 +/- 2662.7 mu m(2) at baseline, T0, and T4, respectively. The coronal diameter of SC decreased significantly from the baseline (33.02 +/- 11.3 mu m) to T0 (26.6 +/- 9.37 mu m) and recovered at T4 (32.3 +/- 9.53 mu m). The SCAR and IOP correlated significantly throughout (R-2 = 0.9944; P < 0.001). C0 significantly correlated with the SCAR at baseline and with changes in the SCAR and IOP from T0 to T4. CONCLUSIONS. Schlemm's canal dimensions are responsible for the IOP-dependent mechanical forces, and these changes appear to directly affect outflow facility.