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Abstract #25030 Published in IGR 12-1
Corneal endothelial cell loss after trabeculectomy or after phacoemulsification, IOL implantation and trabeculectomy in 1 or 2 steps
Soro-Martínez MI; Villegas-Pérez MP; Sobrado-Calvo P; Ruiz-Gómez JM; Miralles de Imperial Mora-Figueroa JGraefe's Archive for Clinical and Experimental Ophthalmology 2010; 248: 249-256
BACKGROUND: To assess endothelial cell damage after glaucoma surgery and combined glaucoma and cataract surgery in one or two steps using confocal biomicroscopy. METHODS: This is an observational retrospective study. Eighty eyes from 62 patients between 60 and 83 years of age were studied. Eyes fell into a control group (n = 21) and three experimental groups, in which trabeculectomy (group 1; n = 21) or trabeculectomy and phacoemulsification and intraocular lens implantation had been performed, in one (group 2; n = 21) or two (group 3; n = 17) steps between 6 months and 5 years before. RESULTS: In the control group, mean corneal endothelial cell density (+/-SD) was 2,619 +/- 319 cells/mm(2), whereas in the experimental groups 1, 2 and 3 it was 2,447 +/- 425, 1,968 +/- 342 and 1,551 +/- 323 cells/mm(2) respectively. Cell densities found in the combined surgery groups were significantly smaller than the densities of the control or trabeculectomy groups. The variation coefficient of the endothelial cell area (+/-SD) was 41.19 +/- 7.46% in the control group and 38.9 +/- 6.02, 42.37 +/- 9.53 and 45.71 +/- 11.96% in groups 1, 2 and 3 respectively, differences that were not statistically significant. The percentage of hexagonality (+/-SD) was 51.10 +/- 8.41% in the control group and 51.4 +/- 6.88, 45.13 +/- 8.40 and 42.37 +/- 9.53% in the experimental groups 1, 2 and 3 respectively, but again there were no significant differences between them. CONCLUSIONS: Combined trabeculectomy, phacoemulsification and intraocular lens implantation causes more endothelialcell damage than trabeculectomy alone, and the two-step combined procedure causes more damage to the endothelium than the one-step combined procedure.
Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Universidad de Murcia, Murcia, Spain.
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
