Archivos de la Sociedad Española de Oftalmología
versión impresa ISSN 0365-6691
ROJAS, B. et al. Structural changes of the anterior chamber angle in primary congenital glaucoma with respect to normal development. Arch Soc Esp Oftalmol [online]. 2006, vol.81, n.2, pp.65-71. ISSN 0365-6691.
Purpose: To compare findings of normal angles with those from primary congenital glaucoma in order to clarify the pathogenic mechanisms of the disease and to explain the success of surgical treatment in some of these patients. Methods: Adult normal eyes from cadavers and fragments of surgical trabeculectomies from patients with primary congenital glaucoma previously treated with goniotomy were studied. Eyes were processed for examination using light microscopy and scanning electron microscopy techniques. Results: The following was evident in congenital glaucoma: 1) high iris insertion; 2) no observable pre-trabecular membrane, but enlarged trabeculae with diminished inter-trabecular spaces; 3) Schlemms canal (SC) apparently normal, with vacuoles in the wall indicating normal functioning; 4) sectioning of the abnormal trabecular tissue during goniotomy allowed repositioning of the angle structures and hence the appearance of the angular recess. Conclusions: Anomalies of the trabecular structures in primary congenital glaucoma do not always parallel an abnormal development of the SC and the collector channels. This fact could explain the success of goniotomy in this type of glaucoma.
Palabras clave : Eye; Schlemms canal; trabecular meshwork; congenital glaucoma; electron microscopy.