Clinical and morphological evaluation of gold micro shunt after unsuccessful surgical treatment of patients with primary open-angle glaucoma

PURPOSE: To report the clinicopathologic features in a series of patients after ineffective glaucoma surgery with gold micro shunts (GMS) 2 years after the procedure. METHODS: This was an interventional case series study including two cases of GMS and two of GMS+ removal. Each specimen was sectioned into three portions: proximal, middle, and distal, and embedded into paraffin blocks, cut into 3 μm sections and stained with hematoxylin and eosin and Masson's trichrome. In the case of inflammatory infiltrations a reaction with an LCA (CD45) monoclonal antibody was performed. RESULTS: Mean IOP before GMS removal was 28.8±4.3 mm Hg, and the patients were administered 2.3±0.5 anti-glaucoma drugs. The progression of changes in the visual field was observed in all cases. In three cases different grade intensification of corneal decompression was observed. Colonization of the connective tissue was found in the channels and around the microimplant in all cases. In two cases infiltration was detected from giant polynuclear and mononuclear cells. CONCLUSIONS: Connective tissue colonization was the cause of GMS obstruction. This can be a non-inflammatory process, but it may also result from chronic inflammation occurring in the suprachoroidal space.