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Romeo Altafini, Riccardo Melis, Simonetta Morselli; Comparison between Endhotelial Cells Loss After Phaco with ExPress Implant and Fixed Combination Theraphy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3736.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate corneal endothelial cells loss after phaco with ExPress implant in one eye compared to fixed combined therapy in contralateral eye
twenty eyes of ten patients affected by cataract and open angle glaucoma treated with latanoprost 0.005 % / timolol 0.5% fixed combination before surgery underwent to phaco with Ex-press implant in one eye (group 1 ) and only pharmacologic latanoprost 0.005% / timolol 0,5% fixed combination treatment in contralateral eye (group 2) . There were no statistically significant differences in age, sex, anterior chamber depth and axial length. Non contact corneal specular microscopy (Tomey 3000 tm) was performed in all eyes before and 1, 3, 6 months after surgery. Endothelial cell density (CCD), coefficient of variation in cell size (CV) and percentage of hexagram cells (HEX) between the two groups were considered before after surgery and during therapy in contralateral eye. One-way analysis of variance (ANOVA) was used to analyzed endothelial cells loss differences between two groups.
The mean preoperative endothelial cell density in group 1 (ECD) was 2144 cells/mm(2) ± 267 (SD) and was 2203 ± 269 cells/mm(2) in the group 2 (P=.431). Postoperatively the mean endothelial cells loss was 8.8% at 1 month, 10.5% at 3 months and 12,6 % at 6 months in group 1 and 0,1% at 1 month, 0,2% at 3 months and 0,25 % at 6 months in the group 2 after six months. The changes were statistically significant compared with those at baseline and those of the contralateral eye at all time points during the study period (P < .05). The superior area, the closest site to ExPress implant, showed the higher decrease in endothelial cell density, by 18.5%, whereas the central cornea showed the less decrease. The percentage of hexagonal cells and coefficient of variation in cell size were not different between the two groups preoperatively or postoperatively. The difference was not statistically significative.
Our results suggest that corneal endothelial cell loss was significantly high in group 1, six months after surgery. The endothelial cells count was not different in group 2 after surgery in controlateral eye. These results suggest that latanoprost 0.005 / timolol 0,5% fixed combination treatment theraphy doesn’t influence the endothelial cells loss even after six months of therapy. The endothelial cells loss in group 1 was only due to surgical trauma.
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