Abstract:
To compare the effect of trabeculectomy and deep sclerectomy on the corneal endothelium.
In a prospective study 62 eyes of 62 patients were included, scheduled for either a single trabeculectomy (n=18), or a single deep sclerectomy (n=14), or a combined trabeculectomy and phacoemulsification (n=11), or a combined deep sclerectomy and phacoemulsification (n=19). Exclusion criteria were history of corneal disease, ocular trauma, inflammation, or previous glaucoma filtering surgery. Preoperative, 3 months and one year postoperative noncontact specular microscopies were performed on central and superior corneas. Endothelial images were interpreted with a computer–assisted analyzer.
In central cornea, a statistical significant post operative endothelial cell loss was found after trabeculectomy and deep sclerectomy (alone and combined with cataract extraction) at 3 and 12 months ( p<0.0001). Endothelial cell loss (EC loss) was as follows.
In upper cornea, the results were similar to central cornea. These findings demonstrate that endothelial cell loss was moderate 3 and 12 months after glaucoma surgery. However, corneal endothelial cell loss was more important after combined surgeries and trabeculectomies suggesting less corneal damage after deep sclerectomy.
Keywords: cornea: endothelium • cornea: clinical science • anterior segment