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XEN Gel Stent versus trabeculectomy: Short-term effects on corneal endothelial cells
Ali Olgun1, Eyup Duzgun1, Aysegul Mavi Yildiz2
1Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Purpose:
To compare the short-term changes in corneal endothelial cells after trabeculectomy or XEN Gel Stent implantation.
Design:
Prospective, interventional, comparative study.
Methods:
Changes in corneal endothelium in patients that underwent XEN Gel Stent implantation or trabeculectomy were prospectively evaluated. Eighty eyes of 62 diagnosed with open-angle glaucoma were divided into two the trabeculectomy and XEN Gel Stent groups. Corneal specular microscopy was performed at the central cornea using a noncontact specular microscope preoperatively and 3 months after surgery.
Results:
The baseline mean corneal endothelial cell density in the trabeculectomy group was 2390.3 ± 324.8 cells/mm2, and this was significantly reduced to 2148 ± 352.5 cells/mm2 3 months after surgery, representing a cell loss of 10.0% (p < 0.001). The baseline mean corneal endothelial cell density in the XEN Gel Stent group was 2156.2 ±559.7 cells/mm2, and this was significantly reduced to 2098.4 ± 556.2 cells/mm2 3 months after surgery, representing a cell loss of 2.1% (p = 0.002). The corneal endothelial cell density change rate of the trabeculectomy group (-10.0% ± 9.7%) was statistically higher than the XEN Gel Stent group (-2.1% ± 13.8%) (p = 0.002). A statistically significant difference was observed in the trabeculectomy group between the baseline and postoperative values in the coefficient of variation (p = 0.029).
Conclusion:
Trabeculectomy caused more endothelial cell damage than XEN Gel Stent implantation in the short-term follow-up period. The XEN Gel Stent may be the treatment of choice in patients with a significantly low preoperative corneal endothelial cell density.
