A role of Tenon's capsule in formation of the functioning filtering blebs
DOI: 10.32364/2311-7729-2025-25-4-1
O.I. Orenburkina1,2, G.G. Kornilaeva1, M.P. Kornilaeva1, D.I. Koshelev1, S.M. Shamsutdinov1
1Russian Center for Eye and Plastic Surgery, Bashkir State Medical University, Ufa, Russian Federation
2RUDN University, Moscow, Russian Federation
Aim: to show a role and involvement of Tenon's capsule (TC) in formation of effective filtering blebs (FB) in antiglaucoma surgeries.
Patients and Methods: 17 patients (17 eyes) with a history of single-operated advanced open-angle glaucoma (intraocular pressure (IOP): 28 — 35 mmHg, and a median value was 31 mmHg) who underwent an antiglaucoma sponge drainage surgery with a non-biodestructive allograft for medical reasons, were enrolled in the study. The excised drainage system was replaced with the biomaterial to eliminate retention of the outflow of intraocular fluid and to create new topography of the anterior chamber angle. Condition of the outflow tracts was assessed by optical coherence tomography. The course of the postoperative period did not require any special medical support. The follow-up period was 12 months.
Results: all antiglaucoma sponge drainage surgeries were performed without complications. The median IOP value decreased from 31 to 18 mmHg. In the early postoperative period, FB was more elevated in the area of implanted drainage. At the same time, it remained diffuse. Although the FB slightly flattened by the end of the study, it remained diffuse without signs of inflammation.
Conclusion: "layer-by-layer" restoration of the eyeball integumentary structures with mobilization of the TC and bulbar conjunctiva over it after the operation with allograft drainage for glaucoma, is an effective method to form an appropriate FB.
Keywords: glaucoma surgery, allograft, Tenon's capsule, filtering bleb.
For citation: Orenburkina O.I., Kornilaeva G.G., Kornilaeva M.P., Koshelev D.I., Shamsutdinov S.M. A role of Tenon's capsule in formation of the functioning filtering blebs. Russian Journal of Clinical Ophthalmology. 2025;25(4):232–237 (in Russ.). DOI: 10.32364/2311-7729-2025-25-4-1
About the authors:
Olga I. Orenburkina — Dr. Sc. (Med.), Director of the Russian Center for Eye and Plastic Surgery, Bashkir State Medical University; 67/1, Sorge str., Ufa, 450075, Russian Federation; Assistant Professor, Department of Eye Diseases, RUDN University; 6, Miklukho-Maklaya str., Moscow, 117198, Russian Federation; ORCID iD 0000-0001-6815-8208
Guzel G. Kornilaeva — Dr. Sc. (Med.), Leading Scientific Officer, Board-Certified Ophthalmic Surgeon, Russian Center for Eye and Plastic Surgery, Bashkir State Medical University; 67/1, Sorge str., Ufa, 450075, Russian Federation; ORCID iD 0000-0002-1915-0311
Margarita P. Kornilaeva — C. Sc. (Med.), Board-Certified Ophthalmic Surgeon, Head of Ophthalmology Department No. 4 of the Russian Center for Eye and Plastic Surgery, Assistant Professor at the Higher School of Regenerative, Ocular and Plastic Surgery, Bashkir State Medical University; 67/1, Sorge str., Ufa, 450075, Russian Federation; ORCID iD 0000-0003-1433-0206
Dmitryi I. Koshelev — C. Sc. (Biol.), Assistant Professor, Head of the Laboratory of Vision Neurophysiology of the Russian Center for Eye and Plastic Surgery, Bashkir State Medical University; 67/1, Sorge str., Ufa, 450075, Russian Federation; ORCID iD 0000-0001-6173-1059
Salavat M. Shamsutdinov — Ophthalmologist at the Russian Center for Eye and Plastic Surgery, Bashkir State Medical University; 67/1, Sorge str., Ufa, 450075, Russian Federation; ORCID iD 0009-0000-4108-3728
Contact information: Guzel G. Kornilaeva, e-mail: g.kornilaeva@alloplant.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest. Received 20.10.2025.
Revised 27.10.2025.
Accepted 30.10.2025.
2. Schnyder C.C., Shaarawy T., Ravinet E. et al. Free conjunctival autologous graft for bleb repair and bleb reduction after trabeculectomy and nonpenetrating filtering surgery. J Glaucoma. 2002;11(1):10–16. DOI: 10.1097/00061198-200202000-00003
3. Sethi P., Patel R.N., Goldhardt R., Ayyala P.S. Conjunctival advancement with subconjunctival amniotic membrane draping technique for leaking cystic blebs. J Glaucoma. 2016;25(2):188–192. DOI: 10.1097/IJG.00000000000000098
4. Wu Y., Seong Y.J., Li K. et al. Organogenesis and distribution of the ocular lymphatic vessels in the anterior eye. JCI Insight. 2020;5(13):e135121. DOI: 10.1172/jci.insight.135121
5. Петров С.Ю. Современная концепция борьбы с избыточным рубцеванием после фистулизирующей хирургии глаукомы. Противовоспалительные препараты и новые тенденции. Офтальмология. 2017;14(2):99–105. DOI: 10.18008./1816-5095-2017-2-99-105Petrov S.Yu. Modern methods of controlling wound healing after fistulizing glaucoma surgery. Anti-inflammatory drugs and new trends. Ophthalmology in Russia. 2017;14(2):99–105 (in Russ.). DOI: 10.18008/1816-5095-2017-2-99-105
6. Bron A.J., Tripathi R.C., Tripathi B.J. Wolff's anatomy oh the eye and orbit (8th ed). London: Chapman and Hall Medical; 1997.
7. Вит В.В. Строение зрительной системы человека. Одесса: Астропринт; 2003.Vit V.V. Structure of the human visual system. Odessa: Astroprint; 2003 (in Russ.).
8. Юрьева Т.Н., Малышева Ю.В. Особенности репаративного процесса после антиглаукомной хирургии. Национальный журнал глаукома. 2023;22(4):89–98. DOI: 10.53432/2078-4104-2023-22-4-89-98Yuryeva T.N., Malysheva Y.V. Features of the reparative process after antiglaucoma surgery. National Journal of Glaucoma. 2023;22(4):89–98 (in Russ.). DOI: 10.53432/2078-4104-2023-22-4-89-98/NJG.2023
9. Koornneef L. Details of the orbital connective tissue system in the adult. Acta Morphol Neerl Scand. 1977;15(1):1–34. PMID: 920267
10. Mac I., Soltau J.B. Glaucoma-filtering bleb infections. Curr Opin Ophthalmol. 2003;14(2):91–96. DOI: 10.1097/00055735-200304000-00012
11. Wen J.C., Stinnett S.S., Asrani S. Comparison of anterior segment optical coherence tomography bleb grading, moorfields bleb grading system, and intraocular pressure after trabeculectomy. J Glaucoma. 2017;26(5):403–408. DOI: 10.1097/IJG.0000000000000631
12. Wilkinson H.N., Hardman M.J. Wound healing: cellular mechanisms and pathological outcomes. Open Biol. 2020;10(9):200223. DOI: 10.1098/rsob.200223
13. Корнилаева Г.Г., Мусина Л.А., Корнилаева М.П., Шангина О.Р. Топографические особенности формирования путей оттока при глаукоме с применением губчатых аллодренажей. Национальный журнал глаукома. 2024;1(23):22–28. DOI: 10.25700/NJG.2024.03Kornilaeva G.G., Musina L.A., Kornilaeva M.P., Shangina O.R. Topographic features of outflow pathways formation in glaucoma using sponge allografts. National Journal of Glaucoma. 2024;1(23):22–28 (in Russ.). DOI: 10.25700/NJG.2024.03
14. Bouhenni R.A., Al Jadaan I., Rassavong H. et al. Lymphatic and blood vessel density in human conjunctiva after glaucoma filtration surgery. J Glaucoma. 2016;25(1):e35–e38. DOI: 10.1097/IJG.0000000000000293
This work is licensed under a Creative Commons «Attribution» 4.0 License.
