Histopathological changes in the anterior segment with anterior and posterior chamber intraocular lens

Christina Mastromonaco; Matthew Balazsi; Nabil Saheb; Ali Salimi; Miguel N Burnier Jr

doi:10.1016/j.jcjo.2020.05.002

Histopathological changes in the anterior segment with anterior and posterior chamber intraocular lens

Can J Ophthalmol. 2020 Oct;55(5):437-444. doi: 10.1016/j.jcjo.2020.05.002. Epub 2020 Jun 23.

Authors

Christina Mastromonaco¹, Matthew Balazsi², Nabil Saheb³, Ali Salimi⁴, Miguel N Burnier Jr³

Affiliations

¹ Ocular Pathology Laboratory, Department of Pathology and Ophthalmology, The MUHC-McGill University, Montreal, Que. Electronic address: christina.mastromonaco@mail.mcgill.ca.
² Department of Ophthalmology, Faculty of Medicine, Montreal, Qc, Canada.
³ Ocular Pathology Laboratory, Department of Pathology and Ophthalmology, The MUHC-McGill University, Montreal, Que.
⁴ Ocular Pathology Laboratory, Department of Pathology and Ophthalmology, The MUHC-McGill University, Montreal, Que; Department of Ophthalmology, Faculty of Medicine, Montreal, Qc, Canada.

PMID: 32585141
DOI: 10.1016/j.jcjo.2020.05.002

Abstract

Objective: Patients have shown a lowering of intraocular pressure (IOP) after cataract surgery. Histopathology studies have reported trabecular meshwork (TM) changes in pseudophakic eyes with posterior chamber intraocular lens (PCIOL) and have eluded to the mechanisms for IOP decrease. Unlike PCIOLs, TM histopathology changes after implantation of an anterior chamber intraocular lens (ACIOL) have not been studied, to our knowledge. Therefore, this study aims to examine the histopathological changes in both the TM and corneal endothelium among donor eyes with ACIOL, PCIOL, and phakic eyes.

Methods: Forty fixed postmortem donor eyes were obtained, sectioned, and embedded. Slides were stained with Masson's trichrome and CD31 vascular endothelial antibody, and further digitalized. Customized Medical Parachute TMAN software quantified the cellular components, the trabecular extracellular matrix (ECM), ECM fibrosis, and trabecular area. Schlemm's canal and corneal endothelium were quantified across the ACIOL, PCIOL, and phakic groups.

Results: Cellular area component of the TM was lower in the ACIOLs and PCIOLs than in phakic eyes, but statistically significant only between PCIOL and phakic eyes (p = 0.0023). ECM area component, TM fibrosis score and TM lamellae area, ciliary process fibrosis, and CD31 expression in Schlemm's canal showed no differences (p = 0.40, 0.99, 0.10, 0.83, 0.45). Significantly lower corneal endothelial cells were seen in ACIOLs compared with both PCIOLs and phakic eyes (p = 0.0002).

Conclusions: ACIOLs and PCIOLs in our sample group showed that there is loss of cellular components in the TM compared with the phakic eyes, with PCIOLs displaying the least amount of TM cells statistically, in this cohort. The ACIOLs led to a greater loss of corneal endothelial cells than both PCIOLs and phakic eyes after cataract surgery. The endothelial cells in Schlemm's canal did not seem to be affected by the IOL placements. Therefore, this study illustrates that there are histopathological differences seen with the placements of ACIOLs in both TM and cornea.

MeSH terms

Anterior Chamber
Endothelial Cells*
Humans
Lens Implantation, Intraocular
Lenses, Intraocular*
Sclera
Trabecular Meshwork