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内镜下睫状体光凝术与经巩膜睫状体光凝术后人类尸检眼急性结构和组织病理学变化的比较

Comparison of acute structural and histopathological changes in human autopsy eyes after endoscopic cyclophotocoagulation and trans-scleral cyclophotocoagulation.

作者信息

Pantcheva Mina B, Kahook Malik Y, Schuman Joel S, Noecker Robert J

机构信息

UPMC Eye Center, Eye and Ear Institute, University of Pittsburg School of Medicine, Pittsburgh, PA, USA.

出版信息

Br J Ophthalmol. 2007 Feb;91(2):248-52. doi: 10.1136/bjo.2006.103580. Epub 2006 Sep 20.

Abstract

AIM

To study the histological effects of trans-scleral cyclophotocoagulation (TCP) and endoscopic cyclophotocoagulation (ECP) on the ciliary body and other structures collected at autopsy and to compare with untreated controls.

MATERIALS AND METHODS

TCP and ECP were performed on human eyes at autopsy. Detailed histological evaluations were perfomed using light microscopy and scanning electron microscopy on treated eyes and compared with untreated controls.

RESULTS

Histological changes were observed with both light microscopy and scanning electron microscopy for all treated tissues. Tissue treated with TCP showed pronounced tissue disruption of the ciliary body muscle and stroma, ciliary processes, and both pigmented and non-pigmented ciliary epithelium. ECP-treated tissue exhibited pronounced contraction of the ciliary processes with disruption of the ciliary body epithelium, sparing of the ciliary body muscle and less architectural disorganisation. The sclera was not affected by either laser treatment.

CONCLUSIONS

ECP treatment caused less damage to the ciliary body compared with TCP when evaluated by light microscopy and scanning electron microscopy. Compared with TCP, ECP seems to be a more selective form of cyclophotocoagulation, resulting in less tissue disruption while achieving the goal of destroying ciliary body epithelium.

摘要

目的

研究经巩膜睫状体光凝术(TCP)和内镜睫状体光凝术(ECP)对尸检采集的睫状体及其他结构的组织学影响,并与未治疗的对照进行比较。

材料与方法

在尸检的人眼上进行TCP和ECP。对治疗后的眼睛使用光学显微镜和扫描电子显微镜进行详细的组织学评估,并与未治疗的对照进行比较。

结果

所有治疗组织在光学显微镜和扫描电子显微镜下均观察到组织学变化。TCP治疗的组织显示睫状体肌肉和基质、睫状突以及色素性和非色素性睫状体上皮有明显的组织破坏。ECP治疗的组织表现为睫状突明显收缩,睫状体上皮破坏,睫状体肌肉未受影响且结构紊乱较少。两种激光治疗均未影响巩膜。

结论

通过光学显微镜和扫描电子显微镜评估,与TCP相比,ECP治疗对睫状体造成的损伤较小。与TCP相比,ECP似乎是一种更具选择性的睫状体光凝形式,在实现破坏睫状体上皮目标的同时,导致的组织破坏更少。

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