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Br J OphthalmolJanuary 201512 citations

Novel device for expanding Schlemm's canal: a morphological study: Implantation of the Stegmann Canal Expander following viscodilation of Schlemm's canal resulted in permanent expansion of the canal lumen and distension of the trabecular meshwork without complications.

Grieshaber Matthias C, Stegmann Robert, Grieshaber Hans R, Meyer Peter


AI Summary

A novel device and viscodilation permanently expanded Schlemm's canal and stretched the trabecular meshwork in autopsy eyes, potentially improving aqueous outflow and lowering intraocular pressure in glaucoma.

Abstract

This study was performed to assess any changes in Schlemm's canal (SC) in human autopsy eyes possibly resulting from the injection of a viscoelastic substance and implantation of a new device (the Stegmann Canal Expander, SCE) into SC. After the surgical procedure, eyes were fixed, dissected into quartered segments and examined using light and scanning electron microscopy. Tissue sections displayed a marked dilation of SC and of the collector channels compared with untreated control sections. The SC walls were disrupted in some areas due to viscodilation, but not due to SCE implantation. In all eyes, the entire 9-mm length of the SCE was positioned inside the canal, keeping the canal wide open. The SCE diameter of 240 μm remained unchanged after implantation. Injection of a viscoelastic substance into SC leads to marked dilation of SC and collector channels. Implanting the SCE into SC allowed persistent expansion of SC and stretching of the trabecular meshwork. This may increase the permeability of the trabecular meshwork, reduce its resistance to aqueous humour and maintain circumferential flow within SC. Experimental and clinical studies should determine the impact of this new canal expander in terms of lowering intraocular pressure in glaucoma surgery.


MeSH Terms

AgedAged, 80 and overFemaleHumansLimbus CorneaeMaleMicroscopy, Electron, ScanningProstheses and ImplantsResins, SyntheticTissue ExpansionTissue Expansion DevicesTrabecular MeshworkViscosupplements

Key Concepts4

Injection of a viscoelastic substance into Schlemm's canal (SC) in human autopsy eyes leads to marked dilation of SC and collector channels.

MechanismBasic ScienceMorphological studyn=Human autopsy eyesCh2Ch37

The Stegmann Canal Expander (SCE) implanted into Schlemm's canal in human autopsy eyes allowed persistent expansion of SC and stretching of the trabecular meshwork.

MechanismBasic ScienceMorphological studyn=Human autopsy eyesCh2Ch37

The Stegmann Canal Expander (SCE) with a diameter of 240 µm remained unchanged after implantation into Schlemm's canal in human autopsy eyes, keeping the canal wide open along its entire 9-mm length.

MechanismBasic ScienceMorphological studyn=Human autopsy eyesCh2Ch37

The Schlemm's canal walls were disrupted in some areas due to viscodilation, but not due to Stegmann Canal Expander (SCE) implantation in human autopsy eyes.

MechanismBasic ScienceMorphological studyn=Human autopsy eyesCh2Ch37

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