Original articleFiltering Blebs and Aqueous Pathway: An Immunocytological and In Vivo Confocal Microscopy Study
Section snippets
Patients and Methods
In this study, 33 eyes of 29 patients who had previously undergone trabeculectomy were included. They were evaluated and followed up at the Quinze-Vingts National Ophthalmology Hospital, Paris, France. All patients had chronic open-angle glaucoma. Twelve were female and 17 were male, and age ranged from 47 to 83 years (mean ± standard deviation [SD], 66.15±10.48).
Trabeculectomy was performed by 2 of the department's surgeons. After meticulous cauterization of the sclera, a half-thickness
Results
In vivo confocal microscopy examination of functioning blebs showed several distinct characteristics. Conjunctival epithelial cells had a normal appearance. Scattered throughout a normal conjunctival epithelium, numerous optically clear spaces filled with fluid were seen, most likely corresponding to the microcysts observed with the slit lamp and consistent with our previous findings using the same confocal microscopy technique. Outside the bleb area, the conjunctival epithelium was quite
Discussion
Several studies have characterized the histopathology of the bleb conjunctival epithelium. It was stated that under optical and electronic microscopy the epithelium of functioning and failed blebs seemed to be normal.10 The conjunctival epithelium was described as irregular in thickness, containing numerous intraepithelial microcysts in blebs with adjunctive mitomycin C.25 Conjunctival epithelial spongiosis associated with inflammatory changes was reported,26 with focally acantholytic
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Inflammation in Glaucoma: From the back to the front of the eye, and beyond
2021, Progress in Retinal and Eye ResearchCitation Excerpt :Recently, Hayek et al. (2019) used angio-optical coherence tomography (OCT) and demonstrated that a higher conjunctival vascular density is associated with poorer prognosis after surgery, including a higher postoperative IOP and a greater need for needling. Furthermore, it has been suggested that goblet cells may act as aqueous humour pathways after surgery (Amar et al., 2008), and that preoperative goblet cell reduction induced by BAK may have deleterious effects (Baudouin et al., 2019; Rolando et al., 1991). In line with this, Agnifili et al. (2016) reported negative outcomes in cases with reduced goblet cell density, due to chronic inflammation and/or toxic drugs.
Reconsidering the central role of mucins in dry eye and ocular surface diseases
2019, Progress in Retinal and Eye ResearchCitation Excerpt :Functioning blebs are associated with a higher number of intraepithelial microcysts (Meziani et al., 2016) and the absence of GCs and/or microcysts is a factor of poor prognosis after filtering surgery (Baudouin, 2013). Amar et al. demonstrated the presence of numerous GCs, but empty of soluble MUC5AC, at the surface of the functioning blebs contrasting with highly and homogeneously stained GCs outside the limit of the blebs (Amar et al., 2008). These cells appeared to correspond to the microcysts observed at the surface of functioning blebs (Fig. 10).
UV damage of the anterior ocular surface – microstructural evidence by in vivo confocal microscopy
2018, Contact Lens and Anterior EyeCitation Excerpt :The most prominent observations of the ocular surface after the summer sun exposure were conjunctival changes. Those were cysts, which are a non-specific observation of the conjunctiva, previously having been described in a variety of “stress” situations for the anterior ocular surface, including surgery with involvement of the conjunctiva [33,34]. Interestingly, similar cysts were previously described as features of skin damage after UV exposure [28]. [35]
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Manuscript no. 2007-169.
Supported by Quinze-Vingts National Ophthalmology Hospital.