This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (7)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Brian A. Francis, MD; Lee T. Du, MD; Kathryn Najafi, MD; Raghu Murthy, MD; Usha Kurumety, MD; Narsing Rao, MD; Don S. Minckler, MD

Arch Ophthalmol. 2005;123:166-170.

Objectives  To characterize and compare the histological features of conjunctiva obtained during the repair of trabeculectomy and inadvertent blebs and to assess the effects of antifibrotic agents.

Methods  We used routine paraffin processing and light microscopy to examine conjunctival specimens from 28 eyes undergoing late bleb revision: 19 leaking trabeculectomy blebs, 5 nonleaking trabeculectomy blebs, and 4 inadvertent blebs. Quantitative analysis of histological characteristics included conjunctival epithelial thickness, stromal vascularity, squamous metaplasia, stromal inflammatory cell infiltrate, and goblet cell density. The type of surgery, presence of leaks, prior topical medication, and antifibrotic use were correlated with histological findings.

Results  Trabeculectomy blebs (leaking and nonleaking) showed decreases in overall epithelial thickness (P<.02), goblet cell density (P<.001), and vascularity (P<.001) compared with inadvertent bleb controls. Conjunctiva exposed to antifibrotics had fewer layers of epithelial cells than those with no prior exposure (P<.05).

Conclusions  Histological analysis of thin blebs excised following trabeculectomy demonstrated decreases in epithelial thickness and goblet cell density compared with inadvertent blebs. Both leaking and nonleaking trabeculectomy blebs exhibited decreases in localized stromal vascularity and increases in surrounding stromal vascularity compared with normal conjunctiva.

Author Affiliations: The Doheny Eye Institute (Drs Francis, Du, Najafi, Murthy, Kurumety, Rao, and Minckler); and the A. Ray Irvine, Jr, MD, Ocular Pathology Laboratory, Keck School of Medicine, University of Southern California, Los Angeles (Dr Rao).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

In Vivo Confocal Microscopy of Filtering Blebs After Trabeculectomy.
Messmer et al.
Arch Ophthalmol 2006;124:1095-1103.
ABSTRACT | FULL TEXT