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Schlemm's canal after trabeculo-electropuncture (TEP).

F Hoffmann, J P Harnisch

    Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. Albrecht Von Graefe'S Archive for Clinical and Experimental Ophthalmology
    |September 28, 1977
    PubMed
    Summary
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    Histological examination revealed that electroprobe insertion into Schlemm's canal (SC) can cause significant damage to its endothelial lining and septa. This damage may explain insufficient intraocular pressure reduction after surgery.

    Area of Science:

    • Ophthalmology
    • Histology
    • Electron Microscopy

    Background:

    • Schlemm's canal (SC) is crucial for aqueous humor outflow and intraocular pressure (IOP) regulation.
    • Surgical interventions targeting SC can have variable outcomes regarding IOP control.
    • Understanding the microstructural effects of surgical tools on SC is vital for improving glaucoma treatment.

    Purpose of the Study:

    • To investigate the histological and ultrastructural consequences of electroprobe insertion into Schlemm's canal.
    • To correlate observed structural damage with clinical outcomes, specifically IOP control.

    Main Methods:

    • Histological examination of Schlemm's canal from two patients.
    • Electron microscopy to assess ultrastructural integrity.
    • Correlation with clinical data, including intraocular pressure and surgical history.

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    Main Results:

    • Electroprobe insertion in one patient led to destruction of SC septa and endothelial lining.
    • In a patient with recurrent IOP elevation post-TEP surgery, histological analysis revealed a trabecular opening and partial SC lumen obstruction.
    • Adhesion of SC walls and reduced collector channel patency were observed, potentially impairing aqueous humor outflow.

    Conclusions:

    • Damage to Schlemm's canal from electroprobe insertion can compromise its function.
    • Structural alterations in Schlemm's canal may underlie insufficient IOP reduction after glaucoma surgery.
    • These findings highlight the importance of careful surgical technique to preserve SC integrity.