Ultrastructural analysis of explanted CyPass microstents and correlation with clinical findings

• DOI: 10.1007/s00417-022-05620-x
• Publication Date: 2022-03-09T08:02:21Z
• Authors: Lisa Hübner; U. Schlötzer-Schr...; J. M. Weller; B. Hohberger; C. Y. Mardin; R. Lämmer
• Keywords: Pseudoexfoliation syndrome; Pseudoexfoliation; Glaucoma surgery; Glaucoma medication; Decompensation

Abstract Purpose The purpose of this study was to obtain insight into cellular processes after CyPass microstent implantation the supraciliary space. With knowledge, we expected find some reason for surgical failure. Methods Nine microstents 8 patients with primary open-angle glaucoma ( n = 1), pseudoexfoliation 5), uveitic and posttraumatic 1) were explanted due recurrence IOP elevation, corneal decompensation, or persistent hypotony. explants processed light transmission electron microscopy. Results Fibrotic material, consisting collagen fibrils, microfibrils, fibrils produced by activated fibroblasts, detected in stent lumen 4/5 also glaucoma. material present on outer surface within fenestrations majority stents. Complete absence fibrotic reaction noticed 3 9 microstents. Conclusion Although MIGS is known be less invasive than conventional surgery, implants placed suprachoroidal space may adversely affected a tissue resulting implant Understanding mechanisms risk factors leading scarring following antiglaucomatous surgery help develop novel strategies that improve outcome.