Pathologic investigation failure of trabeculotomy.

Purpose: To investigate the reason for failure of trabeculotomy using trabeculectomy (TLE) specimens involving the area of previous trabeculotomy.

Materials And Methods: Thirteen TLE specimens from 13 patients with open-angle glaucoma were processed for transmission electron microscopy and light microscopy, involving immunohistochemical staining of thrombomodulin, D2-40 (podoplanin), and CD34.

Results: All intraocular pressure after trabeculotomy decreased to normal and then returned to the same or a higher level compared with that before TLE.

Trabeculectomy with mitomycin for open-angle glaucoma in phakic vs pseudophakic eyes after phacoemulsification.

Objective: To determine whether previous phacoemulsification adversely affects surgical prognosis of trabeculectomy with mitomycin for open-angle glaucoma.

Methods: The study is a retrospective, consecutive, comparative case series. At 2 clinical centers, we reviewed 226 medical records of eyes with open-angle glaucoma undergoing initial trabeculectomy, including 175 phakic eyes (phakic group) and 51 pseudophakic eyes that had previously undergone phacoemulsification with superior conjunctival incision (pseudophakic group).

Long-term relationship between intraocular pressure and visual field loss in primary open-angle glaucoma.

Purpose: To investigate the dependence upon intraocular pressure (IOP) of the progression of visual field defects in eyes with primary open-angle glaucoma (POAG), in which the mean IOP was maintained at < or =21 mm Hg.

Methods: This study involved 100 eyes with POAG, which were followed up for > or =5 years. The mean IOP levels were maintained at < or =21 mm Hg during the follow-up period.

A case of Chandler's syndrome revealed by ultrastructural studies of the trabecular meshwork.

Purpose: To investigate ultrastructural changes in the aqueous outflow route and discuss the mechanisms associated with intraocular pressure (IOP) elevation in a patient with presumably early stage Chandler's syndrome.

Methods: A 47-year-old man underwent trabeculectomy because of elevated IOP. A specimen obtained during surgery was studied by transmission electron microscopy.

Ultrastructural changes in the trabecular meshwork of human eyes treated with corticosteroids.

Objectives: To study the ultrastructure of the trabecular meshwork in human eyes with corticosteroid-induced glaucoma and to determine whether the changes noted also occur in the eyes of patients with primary open-angle glaucoma (POAG) who have been treated with corticosteroids.

Methods: The trabecular meshwork from 5 patients in whom corticosteroid-induced glaucoma was diagnosed and from 6 patients with POAG who had been treated with systemic or topical corticosteroids for months to years was investigated with light and electron microscopy. None of the eyes with POAG were considered to have corticosteroid-induced elevation of the intraocular pressure.

Ultrastructural changes in the trabecular meshwork of juvenile glaucoma.

Trabeculectomy specimens from 11 patients with juvenile glaucoma were studied by electron microscopy and quantitatively evaluated. In all cases, large amounts of extracellular material arranged in a fingerprint-like pattern, resembling basement-membrane-like material (FBM) was found, similar to that described in steroid-induced glaucoma. This material was found mainly within the inner cribriform and outer corneoscleral regions of the trabecular meshwork, and caused the cribriform layer to be greatly thickened.

Dorzolamide, a topical carbonic anhydrase inhibitor: a two-week dose-response study in patients with glaucoma or ocular hypertension.

We investigated the dose-response relationship of the intraocular pressure-lowering activity of dorzolamide, a novel topical carbonic anhydrase inhibitor previously known as MK-507. A double-masked, randomized, multicenter study of 113 patients with either primary open-angle glaucoma or ocular hypertension was conducted; dorzolamide (0.2, 0.

Clinical features of capsular glaucoma in comparison with primary open-angle glaucoma in Japan.

Clinical features of capsular glaucoma during a recent 15-year period were compared with those of primary open-angle glaucoma (POAG). Out of 1623 new glaucoma patients, 263 patients (16.2%) were capsular glaucoma and 268 (16.

Epidemiology of glaucoma in Japan--a nationwide glaucoma survey.

A population-based, collaborative glaucoma survey was conducted in seven regions throughout Japan, during the years of 1988 and 1989. The total number of subjects examined was 8,126 out of 16,078 residents aged 40 years or older, representing a participation rate of 50.54%.

Phakodonesis in capsular glaucoma: a clinical and electron microscopic study.

Subluxation of the lens and phakodonesis were found in 22 out of 261 patients with capsular glaucoma. The overall incidence of these conditions was 8.4%.

The fine structure of pigment epithelium of the iris in capsular glaucoma.

An electron microscopic study was performed on the pigment epithelium of the iris in 13 patients with capsular glaucoma. Pseudoexfoliative material (PE) was often observed in small depressions or indentations of the cell membrane of the posterior pigment epithelium. PE was also found in the region where the cell membrane was indistinct and took a course perpendicular to the surface of the cell membrane.

Familial amyloidotic polyneuropathy: ocular manifestations with clinicopathological observation.

Clinical findings of ocular involvement in two patients with familial amyloidotic polyneuropathy are described. Both cases revealed irregular pupillary margin, white membranous material on the pupillary border and on the lens surface. Open-angle glaucoma was found in one case, and ocular hypertension in the other.

The fine structure of the cribriform meshwork in normal and glaucomatous eyes as seen in tangential sections.

Electron microscopic serial sections in a tangential plane through the inner wall of Schlemm's canal and the trabecular meshwork in normal and glaucomatous eyes revealed a characteristic network of elastic-like fibers (cribriform plexus), which is directly connected to the inner wall endothelium by a special fiber system (connecting fibrils). This cribriform plexus is also connected to the ciliary muscle system. Ciliary muscle tendons were found that not only show the same fine structure as the cribriform plexus but also join it.

Ultrahistochemical studies on tangential sections of the trabecular meshwork in normal and glaucomatous eyes.

The composition of the extracellular material of the cribriform meshwork was compared in five normal and 13 glaucomatous eyes of the same age group (58 to 70 years). Enzymatic digestion and histochemical methods applicable to electron microscopy were used. In both groups of eyes the ground substance was sensitive to chondroitinase ABC, and also the other methods showed no qualitative differences between the groups.

Fine structure of trabecular meshwork and iris in pigmentary glaucoma.

Trabecular meshwork and iris were studied by light and electron microscopy in a 40-year-old female with pigmentary glaucoma. Elevation of the intraocular pressure was most likely due to closure the intertrabecular space by pigment granules and large cells resembling clump cells, fibrous substances, and hypertrophied endothelial cells of the trabecular sheet, which had phagocytized pigment granules.