Abstract:
Introduction: Today, the pathogenetic mechanisms that lead to increased
intraocular pressure (IOP) are still unclear, previous studies have identified the area
of the inner wall of Schlemm's canal in combination with the juxtacanal tissue (JCT)
- the area of the trabecular meshwork, as the main site of outflow resistance.
Purpose: To study the condition of the perilimbal tissues of the eye during the
surgical treatment of patients with open-angle glaucoma.
Methods: We included in the examination 29 patients who underwent surgical
treatment for cataracts and made up the main examination group (these are
patients who had complicated cataracts, namely patients with primary open-angle
glaucoma), as well as a comparison group (patients who had cataracts and did not
suffer from glaucoma). The main group, in turn, was divided into two subgroups. In
the first subgroup of the main group, the Tenon's sheath of the area where the antiglaucomatous intervention was performed was studied, in the second subgroup -
the trabeculae.
Results: On histological preparations of patients of I subgroup of main group signs
of neovascularization with proliferation of endotheliocytes were found, which may
indicate a chronic inflammatory process. It was established that the changed nuclei
of fibrous tissue cells, namely increased in size and more intensely colored, may
indicate changes in functions of cells of examined tissue and subsequently, as a
result, may affect postoperative scarring. A significant swelling of surrounding tissue
was observed that could lead to increase in outflow resistance and increase in IOP.
On samples of II subgroup pathological deposition of diffusely located pigment was
noted, which can cause increase in IOP due to blockage of outflow path of
intraocular fluid
Conclusion: The results obtained in the course of the study of changes in the
perilimbal tissues of the eye in patients with primary open-angle glaucoma will open
up new ways of personalized management of such patients. This will make it
possible to formulate additional criteria for the diagnosis and treatment of
glaucoma aimed at overcoming the inflammatory process and prolonging the
postoperative result.
