Clinically successful contact transscleral krypton laser cyclophotocoagulation. Long-term histopathologic and immunohistochemical autopsy findings.
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 alpha-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.
D000199:Actins / Q000032:analysis / Q000276:immunology; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology; D001284:Atrophy; D001344:Autopsy; D018959:CD57 Antigens / Q000032:analysis / Q000276:immunology; D002924:Ciliary Body / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D003238:Connective Tissue / Q000473:pathology; D004848:Epithelium / Q000276:immunology / Q000473:pathology / Q000601:surgery; D005131:Eye Injuries / Q000150:complications; D005902:Glaucoma, Open-Angle / Q000209:etiology / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007124:Immunoenzyme Techniques; D007381:Intermediate Filament Proteins / Q000032:analysis / Q000276:immunology; D007429:Intraocular Pressure; D017075:Laser Coagulation; D008137:Longitudinal Studies; D008297:Male; D012590:Sclera; D013601:T-Lymphocytes / Q000276:immunology
D000199:Actins; D000911:Antibodies, Monoclonal; D018959:CD57 Antigens; D007381:Intermediate Filament Proteins