Premium
Acute ultrastructural changes of the trabecular meshwork after selective laser trabeculoplasty and low power argon laser trabeculoplasty
Author(s) -
Cvenkel Barbara,
Hvala Anastazija,
DrnovšekOlup Brigita,
Gale Nina
Publication year - 2003
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.10203
Subject(s) - trabecular meshwork , enucleation , laser , glaucoma , ultrastructure , ophthalmology , medicine , choroid , materials science , anatomy , optics , surgery , retina , physics
Background and Objectives To compare the histopathological changes in the human trabecular meshwork after low power argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) with a Q‐switched, frequency‐doubled, neodymium:yttrium–aluminium–garnet (Nd:YAG) laser. Study Design/Materials and Methods In gonioscopically normal trabecular meshwork of three patients awaiting enucleation due to malignant melanoma of the choroid, SLT and ALT were performed 1–5 days prior to enucleation. In each eye, the lower half of trabecular meshwork received SLT, one quadrant low power (460 mW) ALT and one quadrant was left untreated. Specimens were evaluated with light and transmission electron microscopy. Results A sharp demarcation line was visible between the laser treated and untreated intact trabecular meshwork after ALT and SLT. Both lasers caused disruption of trabecular beams, but the extent of the damage was smaller after SLT. The collagen component of trabecular beams was mostly amorphous, the long‐spacing collagen was scanty after ALT, but more abundant after SLT. In the intertrabecular spaces fragmented cells and tissue debris with only a few pigmented cells were observed. Some endothelial cells were desquamated, but appeared slightly better preserved after SLT than ALT. Conclusions Our ultrastructural comparison of the morphological changes after low power ALT and SLT in patients demonstrated that both lasers caused splitting and fragmentation of the trabecular beams of the trabecular meshwork, but the extent of the damage was smaller and the preservation of long‐spacing collagen better after SLT than after ALT. Lasers Surg. Med. 33:204–208, 2003. © 2003 Wiley‐Liss, Inc.