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Corneal endothelial cell loss after trabeculectomy or after phacoemulsification, IOL implantation and trabeculectomy in 1 or 2 steps

  • Glaucoma
  • Published:
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Abstract

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/mm2, whereas in the experimental groups 1, 2 and 3 it was 2,447 ± 425, 1,968 ± 342 and 1,551 ± 323 cells/mm2 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 endothelial cell damage than trabeculectomy alone, and the two-step combined procedure causes more damage to the endothelium than the one-step combined procedure.

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Acknowledgements

Research Support

Fondo de Investigaciones Sanitarias (FIS) PI060780, Fundación Séneca 05703/PI/07 and 04446/GERM/07, Instituto de Salud Carlos III (ISCIII) Red Temática de Investigación Cooperativa en Oftalmología RD07/0062/001. M.I. Soro-Martínez was supported by a fellowship from: Consejería de Sanidad de la Región de Murcia (Proyecto Piloto de viabilidad de la incorporación de Ópticos Optometristas al Servicio Murciano de Salud).

A brief account of this work has been presented in poster form at the 84 Congreso de la Sociedad Española de Oftalmología, which took place in Sevilla (España) from the 23rd to the 27th of September 2008.

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Authors and Affiliations

  1. Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Universidad de Murcia, Murcia, Spain

    María I. Soro-Martínez, María P. Villegas-Pérez, Paloma Sobrado-Calvo & Jaime Miralles de Imperial Mora-Figueroa

  2. Hospital General Universitario Reina Sofía, Murcia, Spain

    María I. Soro-Martínez, María P. Villegas-Pérez, Paloma Sobrado-Calvo & Jaime Miralles de Imperial Mora-Figueroa

  3. Departamento de Estadística e Investigación Operativa, Universidad de Murcia, Murcia, Spain

    José M. Ruiz-Gómez

  4. Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, 30100, Espinardo, Murcia, Spain

    María P. Villegas-Pérez

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  1. María I. Soro-Martínez
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Correspondence to María P. Villegas-Pérez.

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None of the authors has a proprietary interest in the products or devices mentioned in the article.

The study was performed with informed consent and following all the guidelines for experimental investigations required by the European Union for Clinical Research.

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Soro-Martínez, M.I., Villegas-Pérez, M.P., Sobrado-Calvo, P. et al. Corneal endothelial cell loss after trabeculectomy or after phacoemulsification, IOL implantation and trabeculectomy in 1 or 2 steps. Graefes Arch Clin Exp Ophthalmol 248, 249–256 (2010). https://doi.org/10.1007/s00417-009-1185-4

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  • DOI: https://doi.org/10.1007/s00417-009-1185-4

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