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Viscocanalostomy in rhesus monkeys.
Ernst R Tamm1, Roberto G Carassa, Daniel M Albert
1Department of Anatomy, Molecular Anatomy, and Embryology, University of Erlangen-Nürnberg, Germany.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|December 15, 2004
Summary
Viscocanalostomy in monkeys increased aqueous humor outflow by disrupting Schlemm canal's inner wall endothelium. Sodium hyaluronate may prevent healing, maintaining lower intraocular pressure.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Innovation
Background:
- Viscocanalostomy is a surgical procedure aimed at enhancing aqueous humor outflow.
- Understanding the structural and functional changes post-viscocanalostomy is crucial for glaucoma treatment.
- Previous studies have suggested potential benefits, but detailed structural analysis is limited.
Purpose of the Study:
- To investigate the structural alterations in Schlemm canal and surrounding tissues after viscocanalostomy.
- To assess the impact of viscocanalostomy on aqueous humor outflow facility in a primate model.
- To elucidate the mechanisms behind changes in outflow resistance following the procedure.
Main Methods:
- Viscocanalostomy was performed on four rhesus monkeys.
- Aqueous humor outflow facility was measured before and after surgery.
- Eyes were analyzed using light and electron microscopy at 36 or 63 days post-operation.
Main Results:
- Scar tissue replaced Schlemm canal at the surgical site; juxtacanalicular zone showed homogeneous material (likely sodium hyaluronate).
- Defects in the inner and outer walls of Schlemm canal endothelium were observed, with thrombocytes covering some defects.
- Postoperative outflow facility was approximately 30% higher in treated eyes compared to controls.
Conclusions:
- Increased outflow facility is attributed to disruptions in Schlemm canal's inner wall endothelium and juxtacanalicular zone disorganization.
- Sodium hyaluronate may impede the repair of these endothelial defects, potentially by interfering with thrombocyte function.
- Viscocanalostomy may reduce outflow resistance in primates via persistent endothelial disruption, similar to affected areas in human primary open-angle glaucoma.