Journal of the Korean Ophthalmological Society 1987;28(1):93-101.
Published online January 1, 1987.
A Histologic Study of Filtering Wounds After Fistulizing Surgery.
Wan Ki Lee, Byoung Suck Lee, Hai Ryun Jung
Department of Ophthalmology, Korea University, College of Medicine, Seoul, Korea.
녹내장누공수술후 여과창의 (濾過創) 조직학적 연구
이완기(Wan Ki Lee),이병석(Byung Suk Lee),정해륜(Hae Ryun Chung)
Abstract
When a glaucoma filtering operation fails, the causes may be categorized as intraocular, scleral, or extraocular. Some authors have implicated that extraocular causes of failure are due to closure of the external opening by connective tissue. This histologic investigation was undertaken to examine the surgical wounds of 8 experimental subjects including 4 albino and 4 pigmented rabbits. Under general anesthesia by pentothal sodium, a single punch sclerectomy was performed on each right eye. A trabeculectomy was performed on the left eye. Seven and ten days following surgery, globes were removed and immediately fixed in Karnovsky's fixation solution. Following fixation, globes were bisected through surgical wounds, and one-half was studied using standard light microscopy. The other one-half specimens were blocked and processed for transmission electron microscopy. The results of the evaluations were as follows: 1. Full thickness sclerectomy wounds healed by ingrowth of fibroblasts from subconjunctival and episcleral tissue, but trabeculectomy wounds showed no communication with extrascleral tissue. 2. Quantitatively, proliferation of fibroblasts were more exuberant in the sclerectomied eyes compared to trabeculectomies. 3. There was no evidence of significant difference between albino and pigmented rabbits. 4. The granulation tissue composed mainly of fibroblasts resembles smooth muscle cell(myofibroblasts) and extracellular collagen constituents. Ultrastructurally, these cells showed massive bundles of intracytoplasmic microfilaments with scattered dense bodies, wrinkled and folded nuclei indicative cellular contraction, and abundant cisternae of rough endoplasmic reticulum informative activity of cellular proliferation. From those results, author conclude that smooth muscle antagonists may inhibit the proliferation of myofibroblasts after glaucoma filtering operations.


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