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Results for “Trabecular Meshwork”

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PubMed1994

[Effects of porcine pancreatic elastase-1 on elastin in human trabecular meshwork--Immunohistochemical studies: Report 2].

The aim of this study was to confirm the penetration of porcine pancreatic elastase-1 (PPE) into the aqueous humor and trabecular tissue through blood vessels. First, alpha 1-antitrypsin-elastase complex (alpha 1 A-EL) was administered to rats to determine the penetration of alpha 1 A-EL into the trabecular tissue by light microscopic analysis with immunohistochemistry and by electron microscopic analysis with protein A-gold immunohistochemical staining. Secondly, the penetration of PPE into the aqueous humor of the patients given PPE was estimated by Western blot analysis. Finally, human trabecular tissues were sectioned for electron microscopy. The sections were soaked in the aqueous humor and the changes of immunolocalization of elastin in the tissues was evaluated with protein A-gold immunohistochemical staining. The trabecular tissues of the alpha 1 A-EL-treated rats showed a positive immunoreaction under the light microscope, and labelling by gold particles was demonstrated in the trabecular tissues by electron microscope. Western blot analysis proved that there was alpha 1 A-EL in the aqueous humor obtained from PPE-administered patients, but not in the aqueous humor of control patients. The gold particles showing the presence of elastin were less abundant in the specimens exposed to the aqueous humor of PPE-administered patients than in that of control patients.

Adult↗
PubMed2002

Trabecular meshwork bypass tube shunt: initial case series.

AIMS: This study describes a prospective consecutive case series of the initial six eyes of five patients undergoing implantation of the trabecular bypass tube shunt. METHODS: A prospective consecutive case series. The initial six eyes of five patients with uncontrolled open angle glaucoma who had never previously undergone ocular surgery. Implantation of the trabecular bypass tube shunt measuring 150 micro m outer diameter and 50 micro m inner diameter was performed with the distal end placed in Schlemm's canal and the proximal end in the anterior chamber. The main outcome measures were visual acuity, intraocular pressure, glaucoma medication use. RESULTS: The tube was successfully implanted in five of six eyes. In four eyes longer term follow up of 5-9 months showed no loss of visual acuity with decreased intraocular pressure from preoperative levels (mean 23.4-16.5 mm Hg) and reduced requirement of glaucoma medications (mean 3-0.5). In a subset of two eyes, there was no measured increase in aqueous flare or reduction of endothelial cell count. In one eye the tube was explanted because of presumed misplacement by excessive bleeding during surgery. Two eyes showed a diffuse bleb. CONCLUSIONS: This study reports the initial experience with a novel approach to surgical glaucoma therapy. This very small tube allows a direct communication to be established between the anterior chamber and Schlemm's canal, effecting a trabecular bypass. In this small number of eyes this procedure reduced intraocular pressure and the need for glaucoma medications without appreciable side effects.

Adult↗
PubMed1991

Expression of matrix metalloproteinases and inhibitor by human trabecular meshwork.

Extracellular matrix (ECM) turnover and remodeling are initiated, at least in part, by the regulated secretion of members of a family of matrix metalloproteinases. Human and bovine trabecular mesh-work in culture secrete interstitial collagenase, both the 72- and the 92-kD forms of type IV collagenase (gelatinases) and stromelysin, and the tissue inhibitor of metalloproteinases (TIMP). These proteinases and TIMP were identified by immunoblotting western transfers from sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) using several specific antiprotein and antipeptide polyclonal antibodies. Gelatinase and stromelysin enzymatic activities were also analyzed by substrate SDS-PAGE, in which proteinase substrates were polymerized into the gels before electrophoresis to allow subsequent activity assays. These matrix metalloproteinases and TIMP are secreted at low basal levels into trabecular culture medium; their secretion levels are increased several-fold by treatment of the cultures with the phorbol mitogen. 12-O-tetradecanoylphorbol-13-acetate (TPA). Characteristics of the trabecular matrix metalloproteinases and TIMP are similar to those secreted by numerous other tissues, including the retinal pigment epithelium. These proteinases may serve an important role in the maintenance and regulation of the trabecular extracellular matrix and, subsequently, of the aqueous humor outflow pathway in normal and glaucomatous eyes.

Animals↗
PubMed1999

Goniocurettage for removing trabecular meshwork: clinical results of a new surgical technique in advanced chronic open-angle glaucoma.

PURPOSE: To elucidate the long-term outcome of goniocurettage as a new technique in trabecular microsurgery for advanced open-angle glaucoma. METHODS: In a prospective, nonrandomized clinical trial, 25 eyes of 25 patients with a mean age +/- SD of 72.7+/-10.1 years (range, 50 to 89 years) with uncontrolled chronic open-angle glaucoma that had undergone failed filtering procedures were treated by goniocurettage. Trabecular tissue was scraped away from the chamber angle by means of an instrument similar to a microchalazion curette (diameter, 300 microm). RESULTS: Before surgery, intraocular pressure ranged from 29 to 48 mm Hg (mean +/- SD, 34.7+/-7.1 mm Hg), and mean number of antiglaucoma medications was 2.2+/-0.56. Follow-up averaged (+/-SD) 32.6+/-8.1 months (range, 30 to 45 months). Overall success, defined as postoperative intraocular pressure of 19 mm Hg or less with one pressure-reducing agent, was attained in 15 eyes (60%), with five eyes (20%) being controlled without medication. Considering all successfully treated patients, the mean intraocular pressure was 17.7+/-3.1 mm Hg (range, 10 to 19 mm Hg) at the final visit. Mean intraocular pressure reduction was 17.1+/-7.1 mm Hg in these eyes, representing a net decrease from baseline of 49%. Number of antiglaucoma medications dropped to 0.63+/-0.29. Complications included localized Descemet membrane detachment in five eyes (20%) and moderate anterior chamber bleeding in four eyes (16%). CONCLUSIONS: This new surgical technique can effectively control intraocular pressure for long periods of time in patients with open-angle glaucoma and a history of failed filtering procedures. Goniocurettage may be a suitable alternative to surgical treatment of glaucoma patients with excessive conjunctival scarification.

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