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Abstract #9962 Published in IGR 5-3
Acute ultrastructural changes of the trabecular meshwork after selective laser trabeculoplasty and low power argon laser trabeculoplasty
Cvenkel B; Hvala A; Drnovsek-Olup B; Gale NLasers in Surgery and Medicine 2003; 33: 204-208
BACKGROUND AND OBJECTIVES: To compare the histopathological changes in the human trabecular meshwork after low power argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) with a Q-switched, frequency-doubled Nd:YAG laser. STUDY DESIGN/MATERIAL AND METHODS: In the gonioscopically normal trabecular meshwork of three patients awaiting enucleation due to malignant melanoma of the choroid, SLT and ALT were performed one to five days prior to enucleation. In each eye, the lower half of the trabecular meshwork underwent SLT, one quadrant low power (460 mW) ALT, and one quadrant was left untreated. Specimens were evaluated with light and transmission electron microscopy. RESULTS: A sharp demarcation line was visible between the laser treated and untreated intact trabecular meshwork after ALT and SLT. Both lasers caused disruption of the trabecular beams, but the extent of the damage was smaller after SLT. The collagen component of the trabecular beams was mostly amorphous, the long-spacing collagen was scanty after ALT, but more abundant after SLT. In the intertrabecular spaces, fragmented cells and tissue debris with only a few pigmented cells were observed. Some endothelial cells were desquamated, but appeared slightly better preserved after SLT than after ALT. CONCLUSIONS: This ultrastructural comparison of the morphological changes after low power ALT and SLT in patients demonstrated that both lasers caused splitting and fragmentation of the trabecular beams of the trabecular meshwork, but the extent of the damage was smaller and the preservation of long-spacing collagen better after SLT than after ALT.
Dr. B. Cvenkel, Eye Clinic, University Medical Centre Ljubljana, Zaloska 29a, 1525 Ljubljana
Classification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
