Grieshaber Matthias C, Stegmann Robert, Grieshaber Hans R, Meyer Peter
Department of Ophthalmology, University of Basel, Basel, Switzerland Department of Ophthalmology, Medical University of Southern Africa, Medunsa, South Africa.
Department of Ophthalmology, Medical University of Southern Africa, Medunsa, South Africa.
Br J Ophthalmol. 2015 Jul;99(7):875-7. doi: 10.1136/bjophthalmol-2014-305540. Epub 2015 Jan 18.
This study was performed to assess any changes in Schlemm's canal (SC) in human autopsy eyes possibly resulting from the injection of a viscoelastic substance and implantation of a new device (the Stegmann Canal Expander, SCE) into SC. After the surgical procedure, eyes were fixed, dissected into quartered segments and examined using light and scanning electron microscopy. Tissue sections displayed a marked dilation of SC and of the collector channels compared with untreated control sections. The SC walls were disrupted in some areas due to viscodilation, but not due to SCE implantation. In all eyes, the entire 9-mm length of the SCE was positioned inside the canal, keeping the canal wide open. The SCE diameter of 240 μm remained unchanged after implantation. Injection of a viscoelastic substance into SC leads to marked dilation of SC and collector channels. Implanting the SCE into SC allowed persistent expansion of SC and stretching of the trabecular meshwork. This may increase the permeability of the trabecular meshwork, reduce its resistance to aqueous humour and maintain circumferential flow within SC. Experimental and clinical studies should determine the impact of this new canal expander in terms of lowering intraocular pressure in glaucoma surgery.
本研究旨在评估在人类尸检眼中,向施莱姆管(SC)注射粘弹性物质以及在SC中植入新装置(施特格曼管扩张器,SCE)可能导致的SC变化。手术操作后,将眼睛固定,切成四等份并使用光学显微镜和扫描电子显微镜进行检查。与未处理的对照切片相比,组织切片显示SC和集合管明显扩张。SC壁在某些区域因粘弹性扩张而破坏,但并非因植入SCE所致。在所有眼中,SCE的整个9毫米长度均位于管内,使管保持开放。植入后SCE的直径240μm保持不变。向SC注射粘弹性物质会导致SC和集合管明显扩张。将SCE植入SC可使SC持续扩张并拉伸小梁网。这可能会增加小梁网的通透性,降低其对房水的阻力并维持SC内的周向流动。实验和临床研究应确定这种新型管扩张器在青光眼手术中降低眼压方面的影响。