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Morphologic and Cellular Changes Induced by Selective Laser Trabeculoplasty.

Meenakashi Gupta1, Jae Young Heo2, Haiyan Gong3

  • 1Department of Ophthalmology, New York Eye & Ear Infirmary of Mt. Sinai, New York, NY, USA.

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|May 6, 2022
PubMed
Summary

Selective laser trabeculoplasty (SLT) disrupts trabecular meshwork (TM) endothelial cells but stimulates TM cell proliferation and DNA synthesis days after treatment, offering insights into IOP reduction mechanisms.

Keywords:
DNA synthesiselectron microscopyglaucomaselective laser trabeculoplasty

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Area of Science:

  • Ophthalmology
  • Cell Biology
  • Biomedical Engineering

Background:

  • Selective laser trabeculoplasty (SLT) is a common glaucoma treatment to lower intraocular pressure (IOP).
  • The precise cellular mechanisms driving SLT's IOP-lowering effects remain incompletely understood.
  • Investigating cellular and morphological changes in the trabecular meshwork (TM) post-SLT is crucial for understanding its efficacy.

Purpose of the Study:

  • To evaluate the morphologic and cellular changes in human trabecular meshwork (TM) tissue explants after SLT treatment.
  • To assess DNA synthesis and cell proliferation in the TM following SLT.
  • To elucidate the cellular-level mechanisms underlying SLT's therapeutic effects.

Main Methods:

  • Human corneoscleral rim tissues were treated with SLT and compared to untreated controls.
  • Light microscopy (LM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM) were used for morphological analysis.
  • Click-iT 5-ethynyl-2'-deoxyuridine (EdU) and confocal microscopy assessed DNA synthesis and cell proliferation.

Main Results:

  • SLT caused mild disruption of superficial trabecular beams and uveal TM.
  • Endothelial cells were ablated from undamaged beams, though some superficial destruction was not visible at higher SEM magnification.
  • Increased mitotic activity and DNA synthesis were observed near Schlemm's canal lining several days post-SLT.

Conclusions:

  • SLT treatment disrupts corneoscleral TM endothelial cells and causes superficial ultrastructural changes to the uveal TM.
  • A trend towards time-dependent increases in DNA synthesis and mitotic activity (cell proliferation) was noted at 7 days post-treatment.
  • These findings provide cellular insights into the mechanism of IOP reduction by SLT.