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Abstract #10033 Published in IGR 5-3
Pathological study of the deep scleral flap and external trabecular membrane obtained from non-penetrating trabecular surgery
Sun X; Wang Y; Meng FChinese Journal of Ophthalmology 2003; 39: 462-465
OBJECTIVE: To study the anatomical background of non-penetrating trabecular surgery (NPTS) and to explore the resistant site of aqueous outflow in primary open angle glaucoma (POAG). METHODS: NPTS was performed in 18 eyes of 12 cases (ten male, two female) with POAG. The age of these patients ranged from 42-65 years. The deep scleral flap and external trabecular membrane were obtained during the surgical procedure and were examined by light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). RESULTS: The start of the collection canal in the outer wall of Schlemm's canal was very narrow, and there was electron dense material (so-called plaques) around the outer wall of Schlemm's canal. The external trabecular membrane consisted of adjacent trabecular meshwork and part of the corneoscleral trabecular meshwork. The number of trabecular cells was decreased, and a large amount of electron dense material was deposited in the adjacent trabecular meshwork. The holes in the corneoscleral trabecular meshwork were small and irregular. In the corneoscleral trabecular meshwork, the trabecular lamellae were thickened, the amount of elastic-like fibers was increased and the trabecular cells, especially the nuclei, were enlarged. In the advanced stage of POAG, a large amount of electron dense material was deposited in the corneoscleral trabecular meshwork, and the intertrabecular spaces were blocked. CONCLUSIONS: The deep scleral flap in NPTS contains the outer wall of Schlemm's canal and the external trabecular membrane, which consists of the inner wall of Schlemm's canal, the adjacent trabecular meshwork, and part of the corneoscleral trabecular meshwork. The main resistant site of aqueous outflow in POAG is situated in the adjacent trabecular meshwork and in part of the corneoscleral trabecular meshwork. The outer wall of Schlemm's canal is another important resistant site for aqueous outflow. LA: Chinese
Dr. X. Sun, Department of Ophthalmology, The Eye and ENT Hospital of Fundan University, Shanghai 200031, China. sunxinghuai@163.com
Classification:
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
