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Mark P Breazzano, Jianyan Huang, Cristina Modak, Srinivas R Sadda, Vikas Chopra, Olivia L Lee; Characterization of corneal endothelium in glaucomatous eyes managed medically or surgically. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2025.
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To describe the characteristics of corneal endothelium of glaucomatous eyes by non-contact specular microscopy. To compare endothelial cell density (ECD) in eyes with medically versus surgically managed glaucoma.
Non-contact specular microscopic examination of the central cornea using Konan NSP-9900 was performed for three groups of eyes from age-matched patients: [Group 1] normal controls (n=41); [Group 2] glaucoma with medical management only (n=15); [Group 3] glaucoma with prior glaucoma surgery (trabeculectomy or tube shunt) ± concurrent medical management (n=11). Any eye with prior corneal or cataract surgery was excluded. The corneal ECD, coefficient of variation (CV) and percentage of hexagonal cells (HEX) were calculated by 2 independent, trained graders using the Konan Center method.
Glaucoma patients collectively had a significantly lower ECD (2407 cells/mm^2 ± 430, mean ± S.D.) than controls (2675 cells/mm^2 ± 210), (p=0.001). Mean ECD was significantly lower in eyes with prior glaucoma surgery (2280 cells/mm^2 ± 539) than controls (p<0.0005). Surgically treated eyes had lower mean ECD as compared to eyes with medically treated glaucoma (2500 cells/mm^2 ± 295), however this difference was not statistically significant (p=0.069). There was no significant difference in CV (p=0.974) or HEX (p=0.970) between the corneal endothelia of these three groups.
Eyes with glaucoma, particularly those with prior trabeculectomy or tube shunt, have lower corneal endothelial cell densities as compared to normal eyes. This reduction of ECD, in the absence of change in CV or HEX, may represent corneal endothelial loss from glaucoma treatment and/or glaucoma itself.
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