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Changes in corneal endothelial cell density after trabeculectomy
Natalie Si-Yi Lee1,2,3, Ru Min Ong4, Keith Ong2,3,5,6,7
1Faculty of Medicine, University of New South Wales, Sydney, Australia.
European Journal of Ophthalmology
|March 31, 2023
Summary
Trabeculectomy significantly decreases corneal endothelial cell density (CECD). Pseudophakic eyes experienced less cell loss, suggesting cataract surgery before trabeculectomy may preserve corneal health.
Area of Science:
- Ophthalmology
- Corneal Science
- Glaucoma Research
Background:
- Glaucoma is a leading cause of blindness globally.
- Trabeculectomy is a key surgical treatment for advanced glaucoma.
- Trabeculectomy can negatively impact corneal endothelial cell density (CECD).
Purpose of the Study:
- To investigate CECD changes following trabeculectomy.
- To identify factors influencing CECD reduction post-surgery.
- To analyze correlations between pre-operative biometry, lens status, and CECD loss.
Main Methods:
- Retrospective analysis of 72 eyes from 60 patients undergoing trabeculectomy.
- Corneal specular microscopy performed pre-operatively and at 6 months post-surgery.
- Comparison of CECD between phakic and pseudophakic eyes, and correlation with clinical factors.
Main Results:
- A significant decrease in mean CECD was observed 6 months post-trabeculectomy (2284 to 2130 cells/mm²).
- Phakic eyes showed significantly greater CECD reduction compared to pseudophakic eyes.
- CECD loss was negatively correlated with pre-operative central corneal thickness and anterior chamber depth.
Conclusions:
- Trabeculectomy leads to significant corneal endothelial cell loss.
- Pseudophakic patients exhibit less CECD reduction after trabeculectomy.
- Consideration of performing cataract surgery before trabeculectomy may be beneficial for preserving corneal endothelium.
