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A Human Corneal Organ Culture Model of Descemet's Stripping Only with Accelerated Healing Stimulated by Engineered Fibroblast Growth Factor 1
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Corneal endothelial cell changes after trabeculectomy and deep sclerectomy.

Stéphane Arnavielle1, Pierre Olivier Lafontaine, Samuel Bidot

  • 1Department of Ophthalmology, University Hospital, Burgundy, Dijon, France.

Journal of Glaucoma
|April 18, 2007
PubMed
Summary

Glaucoma surgery causes moderate corneal endothelial cell loss. Trabeculectomy resulted in greater cell loss than deep sclerectomy, indicating potentially less corneal damage with deep sclerectomy.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Corneal Health

Background:

  • Glaucoma surgery aims to reduce intraocular pressure.
  • Corneal endothelial cells are crucial for maintaining corneal clarity.
  • Understanding the impact of different surgical techniques on the corneal endothelium is important for patient outcomes.

Purpose of the Study:

  • To compare the effects of trabeculectomy and deep sclerectomy on corneal endothelial cell count.
  • To evaluate endothelial cell loss at 3 and 12 months post-surgery.

Main Methods:

  • Prospective comparative study of 62 patients undergoing glaucoma surgery.
  • Surgical groups included trabeculectomy and deep sclerectomy, with and without phacoemulsification.
  • Noncontact specular microscopy assessed central and superior corneal endothelial cells preoperatively and postoperatively at 3 and 12 months.

Main Results:

  • Both trabeculectomy and deep sclerectomy led to statistically significant endothelial cell loss at 3 and 12 months.
  • Penetrating surgery (trabeculectomy) showed greater cell loss (7%) compared to nonpenetrating surgery (deep sclerectomy, 2.6%) in the central cornea.
  • Cell loss was significantly higher after trabeculectomy than sclerectomy in the superior cornea for noncombined surgeries.

Conclusions:

  • Glaucoma surgery, including trabeculectomy and deep sclerectomy, results in moderate corneal endothelial cell loss.
  • Deep sclerectomy appears to cause less corneal damage than trabeculectomy.
  • Further clinical studies are warranted to confirm these findings.