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November 1995

Clinically Successful Contact Transscleral Krypton Laser Cyclophotocoagulation: Long-term Histopathologic and Immunohistochemical Autopsy Findings

Author Affiliations

From the Department of Ophthalmology, Helsinki (Finland) University Central Hospital. The authors have no proprietary interest in marketing this or a competing instrument.

Arch Ophthalmol. 1995;113(11):1447-1453. doi:10.1001/archopht.1995.01100110107033

Objective:  To report long-term histopathologic findings 10 months after contact transscleral krypton cyclophotocoagulation.

Methods:  The tissue response in a successfully treated eye was analyzed by light microscopy and a panel of 11 antibodies to epithelial, mesenchymal, and inflammatory cells.

Results:  A 75-year-old man with uncontrolled angle recession glaucoma was treated with transscleral contact krypton cyclophotocoagulation (17 burns, 3.5 J each) 10 months before his death. The intraocular pressure fell from 28 to 17 mm Hg 6 months after therapy. Confluent scars straddled the posterior pars plicata and the anterior pars plana. The ciliary processes were destroyed, but the sclera and zonules were intact. Vimentin and cytokeratin 8 and 18 persisted in the degenerated ciliary epithelium. The inner connective-tissue layer and the ciliary muscle had atrophied, as shown with antibodies to the HNK-1 epitope, desmin, and α—smooth-muscle actin. Macrophages with phagocytized pigment and single T cells were present instead. No unusual inflammatory infiltrate was present in the choroid of either eye.

Conclusions:  Clinically effective ablation of ciliary processes is achieved with contact krypton laser. Little chronic inflammation and no signs of sympathetic ophthalmia were present. Atrophy of the ciliary muscle may reduce accommodative capacity in younger patients undergoing cyclophotocoagulation.

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