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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
PubMed
Summary

Trabeculectomy significantly decreases corneal endothelial cell density (CECD). Pseudophakic eyes experienced less cell loss, suggesting cataract surgery before trabeculectomy may preserve corneal health.

Keywords:
corneal endotheliumglaucomatrabeculectomy

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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.