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Abstract #92422 Published in IGR 22-1
The long-term postoperative effect of the Baerveldt glaucoma drainage device and of a trabeculectomy on the corneal endothelium
van Kleij JM; Islamaj E; Vermeer KA; Lemij HG; De Waard PWTActa Ophthalmologica 2022; 100: 212-217
PURPOSE: To determine whether the postoperative corneal endothelial cell density (ECD) differs between glaucoma patients who underwent Baerveldt implant (BGI) surgery and patients who underwent a trabeculectomy (TE) over 5 years ago. METHODS: Cross-sectional, observational study including 34 patients who underwent TE and 36 patients who underwent BGI surgery 5-11 years ago, as part of a randomized clinical trial. None of the patients had a history of intraocular surgery prior to their glaucoma surgery. Central and peripheral ECD was measured by using a non-contact specular microscope. RESULTS: Central and peripheral ECD in the TE group was 2285 ± 371 cells/mm (mean ± SD) and 2463 ± 476 cells/mm , respectively. Central and peripheral ECD in the BGI group was 1813 ± 745 cells/mm and 1876 ± 764 cells/mm , respectively. The central and peripheral ECD was statistically significantly higher in the TE group than in the BGI group (p = 0.001 for both). Additional intraocular surgical interventions were more prevalent in the BGI group (23) than in the TE group (5) (p < 0.001). In a subanalysis, without eyes that had undergone additional surgical interventions, only the peripheral ECD was statistically significantly higher in the TE group compared with the BGI group (p = 0.011). For the BGI group, a longer postoperative period resulted in a lower central ECD (r = -0.614, p = 0.004). CONCLUSION: Long-term ECD in eyes that underwent a BGI was considerably lower compared with eyes that underwent a TE, mainly in the peripheral cornea. This suggests that BGI causes a larger decrease of ECD than TE. Additionally, the decrease after BGI appears to continue for a longer period than after TE.
Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Full articleClassification:
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
