Histologic Analysis of Trabecular Meshwork Obtained From Kahook Dual Blade Goniotomy

Swarup S. Swaminathan, Pedro Monsalve, Xiao Yi Zhou, Mabel Enriquez-Algeciras, Sanjoy K Bhattacharya, Sander Dubovy, Anna Junk

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)198-205
Number of pages8
JournalAmerican Journal of Ophthalmology
Volume192
DOIs
StatePublished - Aug 1 2018

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Trabecular Meshwork
Trabeculectomy
Elastin
Collagen
Open Angle Glaucoma
Veterans
Hematoxylin
Eosine Yellowish-(YS)
Intraocular Pressure
Tertiary Care Centers
Glaucoma
Lasers
Coloring Agents
Immunohistochemistry
Staining and Labeling

ASJC Scopus subject areas

  • Ophthalmology

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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 journalArticle

Swaminathan, Swarup S. ; Monsalve, Pedro ; Zhou, Xiao Yi ; Enriquez-Algeciras, Mabel ; Bhattacharya, Sanjoy K ; Dubovy, Sander ; Junk, Anna. / Histologic Analysis of Trabecular Meshwork Obtained From Kahook Dual Blade Goniotomy. In: American Journal of Ophthalmology. 2018 ; Vol. 192. pp. 198-205.
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