CAMBIOS ESTRUCTURALES DEL ÁNGULO DE LA CÁMARA ANTERIOR EN EL GLAUCOMA CONGÉNITO. COMPARACIÓN CON EL DESARROLLO NORMAL STRUCTURAL CHANGES OF THE ANTERIOR CHAMBER ANGLE IN PRIMARY CONGENITAL GLAUCOMA WITH RESPECT TO NORMAL DEVELOPMENT

Purpose: To compare findings of normal angles with those from primary congenital glaucoma in order to clarify the pathogenic mechanisms of the disease and to explain the success of surgical treatment in some of these patients. Methods: Adult normal eyes from cadavers and fragments of surgical trabeculectomies from patients with primary congenital glaucoma previously treated with goniotomy were studied. Eyes were processed for examination using light microscopy and scanning electron microscopy techniques. Results: The following was evident in congenital glaucoma: 1) high iris insertion; 2) no observable pretrabecular membrane, but enlarged trabeculae with diminished inter-trabecular spaces; 3) Schlemm’s canal (SC) apparently normal, with vacuoles in the wall indicating normal functioning; 4) sectioning of the abnormal trabecular tissue during goniotomy allowed repositioning of the angle structures and hence the appearance of the angular recess.