Histologic findings after argon laser trabeculoplasty in glaucomatous eyes. 2007

Douglas H Johnson
Department of Ophthalmology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA. fautsch.michael@mayo.edu

The purpose of the study was to determine histologic findings after successful laser trabeculoplasty in eyes with glaucoma. Previous studies have examined eyes in which laser did not lower intraocular pressure, or examined only the region of the laser burn itself. Nineteen autopsy eyes from 14 donors with either primary open angle or pseudoexfoliative glaucoma that had undergone laser trabeculoplasty during life were studied. Clinical records were used to determine the effect of laser in lowering intraocular pressure (IOP). For comparison, 49 glaucomatous eyes that had not undergone laser, and 55 normal eyes were studied as control eyes. Histologic sections from multiple quadrants of each eye were studied by light microscopy, selecting regions between laser spots when the spots were visible. Meshworks from lasered eyes frequently had regions of an expanded juxtacanalicular region associated with numerous superimposed giant vacuoles partially filling Schlemm's canal. This finding was more common in eyes fixed by posterior chamber perfusion, occurring in 90% (9/10) of lasered eyes, while it was found in only 20% (3/15) of glaucomatous control eyes (p=0.01) and 33% (14/43) of normal eyes (p=0.01). The mean decrease in IOP caused by laser was 34%+/-14%, with mean follow-up time before death of 2.7+/-1.7 years. In eyes fixed by immersion the expanded JCT finding was less common, occurring in 22% (2/9) of lasered eyes, but only 9% (3/34) of glaucomatous control eyes and 8% (1/12) of normal eyes. The mean decrease in IOP in these eyes was 39%+/-10%, with mean follow up of 2.3+/-1.0 years until death. Downgrowth of Descemet's membrane over the meshwork was observed in portions of two of the 19 lasered eyes. In conclusion, laser trabeculoplasty associated with decreased IOP appears to cause a remodeling of the juxtacanalicular region of the meshwork. This may be a dynamic, flow dependent finding, as it was more common in eyes fixed by perfusion. Downgrowth of Descemet's membrane over the meshwork was uncommon.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D003886 Descemet Membrane A layer of the cornea. It is the basal lamina of the CORNEAL ENDOTHELIUM (from which it is secreted) separating it from the CORNEAL STROMA. It is a homogeneous structure composed of fine collagenous filaments, and slowly increases in thickness with age. Lamina Elastica Posterior,Descemet's Membrane,Descemet Membranes,Descemets Membrane,Elastica Posterior, Lamina,Elastica Posteriors, Lamina,Lamina Elastica Posteriors,Membrane, Descemet,Membrane, Descemet's,Membranes, Descemet,Posterior, Lamina Elastica,Posteriors, Lamina Elastica
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D005901 Glaucoma An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed) Glaucomas
D005902 Glaucoma, Open-Angle Glaucoma in which the angle of the anterior chamber is open and the trabecular meshwork does not encroach on the base of the iris. Glaucoma Simplex,Glaucoma, Pigmentary,Glaucoma, Simple,Open-Angle Glaucoma,Chronic Primary Open Angle Glaucoma,Glaucoma, Compensated,Glaucoma, Compensative,Glaucoma, Open Angle,Glaucoma, Primary Open Angle,Glaucoma, Secondary Open Angle,Primary Open Angle Glaucoma,Secondary Open Angle Glaucoma,Compensated Glaucoma,Compensative Glaucoma,Open Angle Glaucoma,Open Angle Glaucomas,Open-Angle Glaucomas,Pigmentary Glaucoma,Simple Glaucoma,Simplex, Glaucoma,Simplices, Glaucoma
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D014129 Trabecular Meshwork A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the SCHLEMM'S CANAL. Meshwork, Trabecular,Meshworks, Trabecular,Trabecular Meshworks
D014130 Trabeculectomy Any surgical procedure for treatment of glaucoma by means of puncture or reshaping of the trabecular meshwork. It includes goniotomy, trabeculectomy, and laser perforation. Goniotomy,Trabeculoplasty,Trabeculotomy,Goniotomies,Trabeculectomies,Trabeculoplasties,Trabeculotomies

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