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Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings
PURPOSE: The purpose of this study was to obtain insight into cellular processes after CyPass microstent implantation into the supraciliary space. With this knowledge, we expected to find some reason for surgical failure. METHODS: Nine CyPass microstents of 8 patients with primary open-angle glaucom...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325823/ https://www.ncbi.nlm.nih.gov/pubmed/35262764 http://dx.doi.org/10.1007/s00417-022-05620-x |
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author | Hübner, Lisa Schlötzer-Schrehardt, U. Weller, J. M. Hohberger, B. Mardin, C. Y. Lämmer, R. |
author_facet | Hübner, Lisa Schlötzer-Schrehardt, U. Weller, J. M. Hohberger, B. Mardin, C. Y. Lämmer, R. |
author_sort | Hübner, Lisa |
collection | PubMed |
description | PURPOSE: The purpose of this study was to obtain insight into cellular processes after CyPass microstent implantation into the supraciliary space. With this knowledge, we expected to find some reason for surgical failure. METHODS: Nine CyPass microstents of 8 patients with primary open-angle glaucoma (n = 1), pseudoexfoliation glaucoma (n = 5), uveitic glaucoma (n = 1), and posttraumatic open-angle glaucoma (n = 1) were explanted due to recurrence of IOP elevation, corneal decompensation, or persistent hypotony. The explants were processed for light and transmission electron microscopy. RESULTS: Fibrotic material, consisting of collagen fibrils, microfibrils, pseudoexfoliation fibrils produced by activated fibroblasts, was detected in the stent lumen of 4/5 pseudoexfoliation glaucoma patients and also in posttraumatic open-angle glaucoma. Fibrotic material was also present on the outer surface and within fenestrations of the majority of stents. Complete absence of fibrotic reaction was noticed in 3 of 9 microstents. CONCLUSION: Although MIGS is known to be less invasive than conventional surgery, implants placed in the suprachoroidal space may be adversely affected by a fibrotic tissue reaction resulting in implant failure. Understanding mechanisms and risk factors leading to fibrotic scarring following antiglaucomatous surgery may help to develop novel strategies that improve surgical outcome. |
format | Online Article Text |
id | pubmed-9325823 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-93258232022-07-28 Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings Hübner, Lisa Schlötzer-Schrehardt, U. Weller, J. M. Hohberger, B. Mardin, C. Y. Lämmer, R. Graefes Arch Clin Exp Ophthalmol Glaucoma PURPOSE: The purpose of this study was to obtain insight into cellular processes after CyPass microstent implantation into the supraciliary space. With this knowledge, we expected to find some reason for surgical failure. METHODS: Nine CyPass microstents of 8 patients with primary open-angle glaucoma (n = 1), pseudoexfoliation glaucoma (n = 5), uveitic glaucoma (n = 1), and posttraumatic open-angle glaucoma (n = 1) were explanted due to recurrence of IOP elevation, corneal decompensation, or persistent hypotony. The explants were processed for light and transmission electron microscopy. RESULTS: Fibrotic material, consisting of collagen fibrils, microfibrils, pseudoexfoliation fibrils produced by activated fibroblasts, was detected in the stent lumen of 4/5 pseudoexfoliation glaucoma patients and also in posttraumatic open-angle glaucoma. Fibrotic material was also present on the outer surface and within fenestrations of the majority of stents. Complete absence of fibrotic reaction was noticed in 3 of 9 microstents. CONCLUSION: Although MIGS is known to be less invasive than conventional surgery, implants placed in the suprachoroidal space may be adversely affected by a fibrotic tissue reaction resulting in implant failure. Understanding mechanisms and risk factors leading to fibrotic scarring following antiglaucomatous surgery may help to develop novel strategies that improve surgical outcome. Springer Berlin Heidelberg 2022-03-09 2022 /pmc/articles/PMC9325823/ /pubmed/35262764 http://dx.doi.org/10.1007/s00417-022-05620-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Glaucoma Hübner, Lisa Schlötzer-Schrehardt, U. Weller, J. M. Hohberger, B. Mardin, C. Y. Lämmer, R. Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title | Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title_full | Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title_fullStr | Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title_full_unstemmed | Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title_short | Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings |
title_sort | ultrastructural analysis of explanted cypass microstents and correlation with clinical findings |
topic | Glaucoma |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325823/ https://www.ncbi.nlm.nih.gov/pubmed/35262764 http://dx.doi.org/10.1007/s00417-022-05620-x |
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