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Related Experiment Videos

Histopathologic features of trabeculectomy surgery.

Anthony C Castelbuono1, W Richard Green

  • 1Eye Pathology Laboratory, Wilmer Institute, USA.

Transactions of the American Ophthalmological Society
|February 20, 2004
PubMed
Summary

Trabeculectomy surgery outcomes vary due to differences in surgical site features. Avoiding posterior resection posterior to the scleral spur may improve glaucoma surgery success rates.

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Area of Science:

  • Ophthalmology
  • Surgical Pathology

Background:

  • Trabeculectomy is a common surgical procedure for medically uncontrolled glaucoma.
  • Significant variability exists in limbal wound design, position, and surgical outcomes.

Purpose of the Study:

  • To histologically examine trabeculectomy surgical sites in human eyes.
  • To explore associations between surgical site features and trabeculectomy success or failure.

Main Methods:

  • Examination of 64 autopsy and enucleated eyes from 53 patients.
  • Analysis of trabeculectomy site position, dimensions, depth, internal opening features, and trabecular meshwork inclusion.
  • Assessment of surgical success by comparing pre- and post-operative intraocular pressures.

Main Results:

  • Statistical differences in success versus failure groups were observed in the presence of a cleft and the location of the posterior incision.
  • Significant variability in the size, position, and pathological features of trabeculectomy sites was noted.

Conclusions:

  • Surgical site variability is a key factor in trabeculectomy outcomes.
  • A posterior resection posterior to the scleral spur may increase the likelihood of surgical failure and should be avoided.

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