Abstract
Purpose: To determine whether there are identifiable, reproducible findings in the trabecular meshwork (TM) of patients with primary open-angle glaucoma (POAG) who underwent Kahook Dual Blade (KDB) goniotomy. Design: Noncomparative retrospective case series. Methods: Tertiary academic referral center, Veterans Affairs Medical Center. Thirteen patients (14 eyes) with POAG (100%) were treated with KDB goniotomy from May to December 2017. Isolated TM tissue was collected from 9 patients (10 eyes) and submitted for histologic analysis. Hematoxylin-eosin, periodic acid–Schiff, and elastin Van Gieson stains were completed, in addition to immunohistochemistry for collagen IV. Results: Mean age of patients was 74.2 ± 6.7 years. Trabecular beams were identified in all 10 specimens, although distorted in 4 samples, of which 3 had a history of laser trabeculoplasty. Collagen IV staining was present in 10 of 10 samples, coating the trabecular beams. Elastin was present in 8 of 10 samples along the trabecular beams. Intraocular pressure and number of glaucoma medications decreased significantly in all cases postoperatively (P <.0001, P =.035, respectively). Conclusions: This pilot study demonstrates that tissue obtained during KDB goniotomy has a high yield of containing TM compared to reported yield of TM in specimens collected from traditional ab externo trabeculectomy (71% vs 20%, respectively). These goniotomy specimens possess sufficient anatomic preservation to be studied histologically. Trabecular meshwork obtained with this procedure may provide a novel modality to study TM dysfunction in open-angle glaucomas.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 198-205 |
| Number of pages | 8 |
| Journal | American Journal of Ophthalmology |
| Volume | 192 |
| DOIs | |
| State | Published - Aug 1 2018 |
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ASJC Scopus subject areas
- Ophthalmology
Cite this
Histologic Analysis of Trabecular Meshwork Obtained From Kahook Dual Blade Goniotomy. / Swaminathan, Swarup S.; Monsalve, Pedro; Zhou, Xiao Yi; Enriquez-Algeciras, Mabel; Bhattacharya, Sanjoy K; Dubovy, Sander; Junk, Anna.
In: American Journal of Ophthalmology, Vol. 192, 01.08.2018, p. 198-205.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Histologic Analysis of Trabecular Meshwork Obtained From Kahook Dual Blade Goniotomy
AU - Swaminathan, Swarup S.
AU - Monsalve, Pedro
AU - Zhou, Xiao Yi
AU - Enriquez-Algeciras, Mabel
AU - Bhattacharya, Sanjoy K
AU - Dubovy, Sander
AU - Junk, Anna
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose: To determine whether there are identifiable, reproducible findings in the trabecular meshwork (TM) of patients with primary open-angle glaucoma (POAG) who underwent Kahook Dual Blade (KDB) goniotomy. Design: Noncomparative retrospective case series. Methods: Tertiary academic referral center, Veterans Affairs Medical Center. Thirteen patients (14 eyes) with POAG (100%) were treated with KDB goniotomy from May to December 2017. Isolated TM tissue was collected from 9 patients (10 eyes) and submitted for histologic analysis. Hematoxylin-eosin, periodic acid–Schiff, and elastin Van Gieson stains were completed, in addition to immunohistochemistry for collagen IV. Results: Mean age of patients was 74.2 ± 6.7 years. Trabecular beams were identified in all 10 specimens, although distorted in 4 samples, of which 3 had a history of laser trabeculoplasty. Collagen IV staining was present in 10 of 10 samples, coating the trabecular beams. Elastin was present in 8 of 10 samples along the trabecular beams. Intraocular pressure and number of glaucoma medications decreased significantly in all cases postoperatively (P <.0001, P =.035, respectively). Conclusions: This pilot study demonstrates that tissue obtained during KDB goniotomy has a high yield of containing TM compared to reported yield of TM in specimens collected from traditional ab externo trabeculectomy (71% vs 20%, respectively). These goniotomy specimens possess sufficient anatomic preservation to be studied histologically. Trabecular meshwork obtained with this procedure may provide a novel modality to study TM dysfunction in open-angle glaucomas.
AB - Purpose: To determine whether there are identifiable, reproducible findings in the trabecular meshwork (TM) of patients with primary open-angle glaucoma (POAG) who underwent Kahook Dual Blade (KDB) goniotomy. Design: Noncomparative retrospective case series. Methods: Tertiary academic referral center, Veterans Affairs Medical Center. Thirteen patients (14 eyes) with POAG (100%) were treated with KDB goniotomy from May to December 2017. Isolated TM tissue was collected from 9 patients (10 eyes) and submitted for histologic analysis. Hematoxylin-eosin, periodic acid–Schiff, and elastin Van Gieson stains were completed, in addition to immunohistochemistry for collagen IV. Results: Mean age of patients was 74.2 ± 6.7 years. Trabecular beams were identified in all 10 specimens, although distorted in 4 samples, of which 3 had a history of laser trabeculoplasty. Collagen IV staining was present in 10 of 10 samples, coating the trabecular beams. Elastin was present in 8 of 10 samples along the trabecular beams. Intraocular pressure and number of glaucoma medications decreased significantly in all cases postoperatively (P <.0001, P =.035, respectively). Conclusions: This pilot study demonstrates that tissue obtained during KDB goniotomy has a high yield of containing TM compared to reported yield of TM in specimens collected from traditional ab externo trabeculectomy (71% vs 20%, respectively). These goniotomy specimens possess sufficient anatomic preservation to be studied histologically. Trabecular meshwork obtained with this procedure may provide a novel modality to study TM dysfunction in open-angle glaucomas.
UR - http://www.scopus.com/inward/record.url?scp=85048857176&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048857176&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2018.05.028
DO - 10.1016/j.ajo.2018.05.028
M3 - Article
C2 - 29883587
AN - SCOPUS:85048857176
VL - 192
SP - 198
EP - 205
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -