The effect of argon laser trabeculoplasty upon the normal human trabecular meshwork.

The effect of argon laser trabeculoplasty (ALT) upon the normal human trabecular meshwork, as determined by scanning and transmission electron microscopy is reported. The lower nasal and temporal quadrants of an eye received ALT 5 and 1 day, respectively, prior to enucleation. Laser impact sites were identified as focal disruptions of trabeculae, together with connective tissue and cellular debris. Surviving trabecular endothelial cells near the laser lesions exhibited signs of phagocytic and migratory activity. Exogenous macrophages also contributed to the clearance of debris. Activated trabecular cells were observed leaving the meshwork by migrating over the corneal endothelium. By 5 days post-ALT increased amounts of trabeculae lacked an endothelial covering. More activated trabecular cells but fewer macrophages were noted. A laser lesion sited close to Schwalbe's line induced, within 5 days, a local corneal endothelial wave front to advance towards it, thus reflecting many late failed ALT specimens that we have seen.