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Clinical science
Effect of trabeculectomy on corneal endothelial cell loss
  1. Kazuyuki Hirooka1,
  2. Eri Nitta2,
  3. Kaori Ukegawa2,
  4. Shino Sato2,
  5. Yoshiaki Kiuchi1
  1. 1 Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
  2. 2 Ophthalmology, Kagawa University, Miki, Japan
  1. Correspondence to Dr Kazuyuki Hirooka, Hiroshima University, Hiroshima 734-8551, Japan; khirooka9{at}gmail.com

Abstract

Aim To investigate changes in corneal endothelial cell density (CECD) after trabeculectomy.

Methods This prospective, observational study followed 117 eyes of 117 patients for 2 years after trabeculectomy. The central cornea was examined by corneal specular microscopy prior to and at every 6 months after the surgery. Survival analysis of patients who exhibited a 10% or less reduction of the postoperative CECD compared with preoperative levels was assessed using the Kaplan-Meier survival curve. A Cox proportional hazards model was used to evaluate prognostic factors for decreasing CECD.

Results At baseline, the mean CECD was 2420±357 cells/mm2, while at 6, 12, 18 and 24 months after surgery, the mean CECD was 2324±373 cells/mm2 (p<0.001), 2276±400 cells/mm2 (p<0.001), 2290±398 cells/mm2 (p<0.001) and 2267±446 cells/mm2 (p<0.001), respectively. At 6, 12, 18 and 24 months after surgery, the results of the Kaplan-Meier survival analysis of the 10% loss of CECD from baseline were 91%, 85%, 83% and 77%, respectively. Uveitic glaucoma was a significant prognostic factor for decreasing CECD (p=0.041).

Conclusions CECD significantly and continuously decreased after trabeculectomy.

  • cornea
  • glaucoma
  • treatment surgery

https://doi.org/10.1136/bjophthalmol-2018-313417

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    Footnotes

    • Contributors KH was responsible for the design, conduct of the study, collection, management, analysis, interpretation of data and preparation of the manuscript. KH and YK reviewed the manuscript. All authors approved the manuscript.

    • Funding This work was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (26462689).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval This study was approved by the Institutional Review Board of the Kagawa University Faculty of Medicine.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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