Congenital glaucoma associated with a chromosomal defect. A histologic study.

A pair of eyes with congenital glaucoma, one treated by goniotomy, was examined by light and electron microscopy. Examination of the drainage angles afforded the opportunity to compare anatomic changes in the treated eye with the surgically unaltered tissue of the fellow eye. The congenital glaucoma appeared to arise from compression of the trabecular meshwork and closure of the intertrabecular and transtrabecular spaces by a discontinuous "membrane" consisting of ectopic trabecular pillars that bridged the drainage angle from the iris root to the normally positioned uveal meshwork. Cleavage of trabecular pillars during goniotomy and conversion of angle architecture to that of a nonglaucomatous neonatal eye suggest that aberrant or ectopic trabecular pillars acted mechanically in maintaining angle compression. The uveal and corneoscleral meshwork and Schlemm's canal are present and appear normal.