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Romeo Altafini, Antonio Maria Fea, Simonetta Morselli, Federico M Grignolo; COMPARISON BETWEEN ENDHOTELIAL CELL LOSS AFTER EXPRESS IMPLANT AND MICS, PHACO MICS SAFE-TRABECULECTOMY AND PHACO WITH HYDRUS IMPLANT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6127.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate corneal endothelial cell loss after phaco with ExPress implant compared to phaco trabeculectomy and phaco with trabecular stent (Hydrus) implant.
Forty eyes of forty patients affected by cataract and open angle glaucoma were randomized to Micro incision cataract surgery (MICS) phaco with Express P50 implant under scleral flap (group 1) or MICS safe-phacotrabeculectomy (group 2) after informed consent and compared to 20 patients underwent phacoemulsification with the new trabecular stent (Hydrus) implant (group 3). All patients were operated by two-site surgery. There were no statistically significant differences in age, sex, anterior chamber depth and axial length in the 3 groups. Non contact corneal specular microscopy (Tomey 3000 tm) was performed before surgery and at the 3rd and 6th months after surgery . Endothelial cell density (CCD), coefficient of variation in cell size (CV) and percentage of hexagram cells (HEX) between the three groups were considered before and after surgery. One-way analysis of variance (ANOVA) was used to analyze endothelial cell loss differences between groups.
The mean preoperative endothelial cell density in group 1 (ECD) was 2144 cells/mm2 ± 267 (SD), 2203 ± 269 cells/mm2 in group 2 (P=.431) and 2461± 315 cells/mm2 in group 3. The mean postoperatively endothelial cell loss at 6th month was 12 ,6 ± 9,4 % in group 1 and 12,3 ± 8,9 % in group 2. In group 3 the mean endothelial cell loss was 11.6±10.6 % .The differences were not statistically significant between the three groups (P >0.05). The percentage of hexagonal cells and coefficient of variation in cell size were not different between the three groups preoperatively or postoperatively.
Endothelial cell loss was not statistically different in the 3 groups. Therefore the implant devices for glaucoma surgery combined with phacoemulsification seem safe up to 6 months.
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