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Editors Selection IGR 9-4
Surgical treatment: MMC
Comment by Paul Palmberg on:
13918 Otago glaucoma surgery outcome study: cytology and immunohistochemical staining of bleb capsules around Molteno implants, Molteno AC; Suter AJ; Fenwick M et al., Investigative Ophthalmology and Visual Science, 2006; 47: 1975-1981
Molteno et al. (567) describe the cytology and immunohistochemistry of the capsules over the reservoirs of Molteno glaucoma implants from non-inflammed eyes with good pressure control obtained two months to 17 years after implantation. All bleb capsules had a thin, cellular external layer with numerous small vessels coursing through regularly arranged collagen fibers, and a thicker, deeper layer that was relatively acellular and had fragmented collagen fibers, and showed signs of both metabolic activation and of cell death, a dynamic process.
The authors suggest that the bleb over a Molteno glaucoma implant undergoes a constant renewal at the surface, where the oxygen tension and interstitial protein levels are higher, and internal degeneration deeper in where aqueous oxygen and protein levels are present.
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