Abstract
Purpose :
To evaluate the changes in corneal endothelial cell density (CECD) after EX-PRESS glaucoma drainage device implantation.
Methods :
This retrospective observational study included consecutive eyes that had undergone EX-PRESS glaucoma drainage device implantation (including combined cataract surgery) between January 2014 and December 2016 at Showa University hospital. All procedures were performed by a single surgeon. The inclusion criterion was more than 6 months follow-up. The exclusion criteria were the presence of any significant ocular diseases and intraocular surgical history, apart from cataract surgery or Ab interno trabeculotomy,in the operated eye. Cases that underwent other intraocular surgeries during the postoperative follow-up were also excluded. Corneal specular microscopy was performed preoperatively (baseline) and at 6, 12, 18, 24, and 36 months postoperatively using a noncontact specular microscope. The postoperative reduction in CECD was assessed, and compared between the group with EX-PRESS device implantation alone (phakia and pseudophakia) and combined cataract surgery group; the postoperative reduction in CECD was also compared among eyes with various diagnoses.All data are expressed as mean ± S.D.Paired t-test was performed to assess the changes in CECD and intraocular pressure (IOP) between baseline and postoperatively, and Welch’s t-test was performed to compare the reduction in CECD across groups. P value <0.05 was considered as significant difference.
Results :
Seventy-five out of the 105 eyes that underwent EX-PRESS implantation surgery were included in this study. A background of the cases is shown in Table 1.The IOP (mmHg) was 23.5 ± 9.9 (n=75) at baseline, and 12.6 ± 5.2 (n=73), 13.2 ± 5.0 (n=66), 14.0 ± 6.1 (n=48), 12.9 ± 3.8 (n=51) and 12.6 ± 4.1 (n=23), at 6, 12, 18, 24, and 36 months postoperatively, respectively. The postoperative IOP was significantly reduced from the baseline. The postoperative reduction in CECD is shown in Table 2.CECD significantly decreased at 18, 24, and 36 months postoperatively. There were no significant differences in the CECD reduction across the types of diagnosis and surgery except at 6 months postoperatively between the groups with EX-PRESS device implantation alone and combined cataract surgery group.
Conclusions :
It is necessary to note the long-term changes in the CECD after EX-PRESS device implantation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.