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      Surgery on the Trabecular Meshwork: Histopathological Evidence

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          ABSTRACT

          Juxtacanalicular (JXT) trabecular meshwork and endothelial lining of Schlemm’s canal have been cited as the loci of aqueous outflow resistance, both in a normal as well as a glaucomatous eye. In this review, we attempt to understand the currently available surgical modalities in light of the available histopathological evidence, regarding localization of outflow resistance.

          How to cite this article: Bhartiya S, Ichhpujani P, Shaarawy T. Surgery on the Trabecular Meshwork: Histopathological Evidence. J Curr Glaucoma Pract 2015;9(2):51-61.

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          Most cited references142

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          Trabeculectomy. Preliminary report of a new method.

          J Cairns (1968)
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            Trabecular meshwork cellularity in primary open-angle glaucoma and nonglaucomatous normals.

            The trabecular meshwork cellularity (cells/unit tissue area) was compared in patients with primary open-angle glaucoma (POAG) with that of nonglaucomatous (NG) individuals. The NG specimens (n = 69) include specimens from the prenatal period (n = 14) as well as the postnatal period to age 98 years (n = 55). The glaucoma specimens (n = 49) covered a wide-range of ages (23-80 years) and were obtained at trabeculectomy (n = 31) or at autopsy (n = 18). Our results show that the trabecular cellularity in NG specimens decreases most rapidly and in a nonlinear manner in the late fetal period and for the first few years of postnatal life. This rapid decline in cellularity then slows down to proceed in a nearly linear manner for the remainder of the 98 years of life studied. The meshworks from patients with POAG have a lower cellularity than normals over the wide range of ages examined, but both types of specimens undergo similar declines in cellularity with age. Thus, the age-cellularity curves for both the NG and POAG specimens are parallel to each other. The loss of cells occurs in a gradient-like manner with the inner tissues being most affected and the outermost tissues least affected. A variety of statistical tests show that these changes in cellularity are highly significant and specific. These findings are compared to the loss of endothelial cells in the cornea and they are discussed in relation to the important clinical characteristics of POAG.
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              Experimental aqueous perfusion in enucleated human eyes.

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                Author and article information

                Contributors
                Journal
                J Curr Glaucoma Pract
                J Curr Glaucoma Pract
                JOCGP
                Journal of Current Glaucoma Practice
                Jaypee Brothers Medical Publishers
                0974-0333
                0975-1947
                May-Aug 2015
                25 September 2015
                : 9
                : 2
                : 51-61
                Affiliations
                Senior Consultant, Glaucoma Facility, Fortis Memorial Research Institute, Gurgaon Haryana, India
                Associate Professor, Department of Ophthalmology, Glaucoma Facility, Government Medical College and Hospital, Chandigarh, India
                Head, Glaucoma Sector, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
                Author notes
                Tarek Shaarawy, Head, Avenue de France 15, CH-1004 Lausanne, Switzerland, Phone: +41 21 626 8224, Fax: +41 21 626 8246, e-mail: tarek.shaarawy@hcuge.cri
                Article
                10.5005/jp-journals-10008-1184
                4750027
                26997835
                9ae002d6-f9ba-4e22-8dcc-f109332b3b5d
                Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.

                This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/

                History
                : 31 March 2015
                : 2 May 2015
                Categories
                Review Article

                aqueous outflow and resistance,histopathological basis of glaucoma surgery,outflow facility,trabecular meshwork.

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