Official ESCRS | European Society of Cataract & Refractive Surgeons


Histopathological software analysis of the trabecular meshwork and corneal endothelium between anterior and posterior chamber intraocular lenses in donor eyes

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Session Details

Session Title: Ocular Pathology/Education & Training

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 14:42

Venue: Free Paper Forum: Podium 4

First Author: : C.Mastromonaco CANADA

Co Author(s): :    M. Balazsi   D. Rao   R. Nojiri   T. Figueiredo   N. Sahib   M. Burnier              

Abstract Details


Posterior intraocular lens (IOLs) are known to lower intraocular pressure (IOP) post-surgery. It has been demonstrated, using histopathology, that there are trabecular meshwork (TM) changes in posterior IOLs when compared to crystalline lenses, which may describe why there is a lowering of IOP. In cases of posterior capsular rupture or inadequate capsular support, an anterior chamber IOL may be implanted. TM changes may also occur upon anterior IOL placement, however, this has never been analyzed. Therefore, this study aims to examine the histopathological changes in both the TM and corneal endothelium among donor eyes with anterior and posterior chamber IOLs.


The MUHC-McGill University Ocular Pathology & Translational Research Laboratory


Forty fixed post-mortem donor eyes with IOL implants from the Minnesota Lions Eye Bank were obtained, along with relevant clinical history. The anterior segments were bisected through the center of the pupil, processed routinely and embedded in paraffin. Slides were stained with Masson’s Trichrome and CD31 vascular endothelial staining antibody, and further digitalized. Customized Medical Parachute TMAN software quantified the cellular components, the trabecular extracellular matrix (ECM), ECM fibrosis and trabecular lamellae area on each slide. Schlemm’s Canal endothelium and corneal endothelium were quantified.


Cellular area component of the TM was significantly lower in the posterior IOLs and also in the anterior IOLs, compared to the natural crystalline lens (p=0.0004). ECM area component, TM fibrosis score, and TM lamellae area and ciliary process fibrosis showed no differences (p=0.38, 0.98, 0.10, 0.83). CD31 stained Schlemm’s Canal endothelium very well, no differences between groups were seen with its expression level (p=0.57). Significantly lower corneal endothelial cells were seen in anterior chamber IOLs compared with both posterior IOLs and the crystalline lenses (p<0001).


Anterior and posterior IOLs in our sample group demonstrated a loss of cellular components in the TM compared to the natural crystalline lenses. The anterior chamber lenses led to a greater loss of corneal endothelial cells post-cataract surgery. There is absence of scaring in the TM, indicating no wound healing in the TM tissue post-surgery. The endothelial cells in Schlemm’s canal do not seem to be affected by the IOL placements.

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