Long-term corneal endothelial cell loss after filtration surgery: analysis using natural language processing.

Area of Science:

• Ophthalmology
• Corneal Science
• Glaucoma Research

Background:

• Glaucoma filtration surgery aims to reduce intraocular pressure (IOP) but can impact corneal health.
• Corneal endothelial cell density (ECD) is crucial for corneal transparency and function.
• Long-term effects of filtration surgery on ECD are not fully understood.

Purpose of the Study:

• To investigate long-term changes in corneal endothelial cell density (ECD) after glaucoma filtration surgery.
• To identify risk factors associated with ECD reduction using automated clinical data extraction.
• To assess the utility of natural language processing in analyzing surgical outcomes.

Main Methods:

• Retrospective analysis of 136 glaucoma patients undergoing filtration surgery.
• Utilized a BERT-based natural language processing system for automated clinical data extraction from 36,561 visits.
• Employed mixed-effects regression models to evaluate factors influencing ECD reduction over time.

Main Results:

• Corneal endothelial cell density (ECD) decreased linearly by ~1% per 100 days up to 1,500 days post-surgery.
• Lower postoperative intraocular pressure (IOP) and longer follow-up duration were significant risk factors for ECD loss.
• No significant association found between ECD loss and glaucoma type, surgical technique, or inflammation.

Conclusions:

• Progressive long-term ECD loss occurs after glaucoma filtration surgery.
• Maintaining lower postoperative IOP is a risk factor for ECD reduction.
• Automated data extraction is effective for long-term surgical outcome analysis.