Effect of trabeculectomy on corneal endothelial cell loss

Hirooka, Kazuyuki; Nitta, Eri; Ukegawa, Kaori; Sato, Shino; Kiuchi, Yoshiaki

doi:10.1136/bjophthalmol-2018-313417

Cited by 30 publications

(34 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Endothelial cell loss was similar in both groups at year 1 (À5.2% after MicroShunt implantation and À6.9% after trabeculectomy), and these results were consistent with other reports of endothelial cell count trends after glaucoma surgery. 24 Our findings align with those reported in a prospective, observational study by Hirooka et al 24 that followed 117 patients for 2 years after trabeculectomy, in which mean ECD decreased significantly from 2420 AE 357 cells/mm 2 at baseline to 2276 AE 400 cells/mm 2 at year 1 (P < 0.01). 24 Long-term follow-up (up to 5 years) is required to fully understand the impact of MicroShunt implantation and trabeculectomy on endothelial cell loss.…”

Section: Discussionsupporting

confidence: 90%

“…24 Our findings align with those reported in a prospective, observational study by Hirooka et al 24 that followed 117 patients for 2 years after trabeculectomy, in which mean ECD decreased significantly from 2420 AE 357 cells/mm 2 at baseline to 2276 AE 400 cells/mm 2 at year 1 (P < 0.01). 24 Long-term follow-up (up to 5 years) is required to fully understand the impact of MicroShunt implantation and trabeculectomy on endothelial cell loss.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Ab-Externo MicroShunt versus Trabeculectomy in Primary Open-Angle Glaucoma

Barnebey²,

et al. 2021

View full text Add to dashboard Cite

for the INN005 Study Group* Purpose: To compare the effectiveness and safety of the MicroShunt versus trabeculectomy in patients with primary open-angle glaucoma (POAG).Design: One-year results from a 2-year, prospective, randomized, multicenter, noninferiority study (NCT01881425) conducted in the United States and Europe.Participants: Eligible patients were aged 40e85 years with intraocular pressure (IOP) !15 and 40 mmHg and mild-to-severe POAG inadequately controlled on maximum tolerated medical therapy.Methods: Patients were randomized 3:1 to undergo stand-alone MicroShunt implantation or trabeculectomy, both performed with adjunctive mitomycin C (0.2 mg/ml for 2 minutes).Main Outcome Measures: The primary effectiveness end point was surgical success, defined as !20% reduction in mean diurnal IOP from baseline (no medication washout) at year 1 without increasing the number of glaucoma medications. Secondary effectiveness end points at year 1 were the mean IOP change from baseline and requirement for postoperative intervention. Additional end points included glaucoma medication use and adverse events.Results: Overall, 395 (MicroShunt) and 132 (trabeculectomy) patients were randomized (mean Humphrey visual field mean deviation, À12.34 decibels [dB]). At year 1, probability of success was lower in the MicroShunt group compared with the trabeculectomy group (53.9% vs. 72.7%, respectively; P < 0.01). In the MicroShunt group, mean IOP AE standard deviation decreased from 21.1 AE 4.9 mmHg at baseline to 14.3 AE 4.3 mmHg (À29.1%; P < 0.01) at year 1, with a mean of 0.6 AE 1.1 glaucoma medications (baseline 3.1 AE 1.0; P < 0.01). In the trabeculectomy group, mean IOP decreased from 21.1 AE 5.0 mmHg to 11.1 AE 4.3 mmHg (À45.4%; P < 0.01), with a mean of 0.3 AE 0.9 glaucoma medications (baseline 3.0 AE 0.9; P < 0.01). Postoperative interventions, including laser suture lysis, were reported in 40.8% (MicroShunt) versus 67.4% (trabeculectomy) of patients (P < 0.01). Reported incidence of transient hypotony was higher in the trabeculectomy group versus the MicroShunt group (49.6% vs. 28.9%; P < 0.01). Vision-threatening complications were uncommon and reported in 1.0% of MicroShunt versus 0.8% of trabeculectomy patients.Conclusions: Probability of success was lower with MicroShunt compared with trabeculectomy. Although reductions in IOP and glaucoma medications over 1 year were observed in both groups, the trabeculectomy group had a lower mean IOP on fewer medications. Ophthalmology 2021;-:1e12

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Ab-Externo MicroShunt versus Trabeculectomy in Primary Open-Angle Glaucoma

Barnebey²,

et al. 2021

View full text Add to dashboard Cite

show abstract

“…At present, the most common aetiology of corneal oedema is cataract surgery [6]. Filtering glaucoma surgery causes less cell loss than cataract surgery [7][8][9][10][11][12][13][14][15][16], but it may also cause significant cell loss, especially if combined with cataract surgery [12,14,17,18].…”

Section: Introductionmentioning

confidence: 99%

Corneal endothelial cell loss after trabeculectomy and phacoemulsification in one or two steps: a prospective study

Soro-Martínez

Imperial-Ollero

Pastor-Montoro

et al. 2021

Eye

View full text Add to dashboard Cite

Objective The objective of this study was to analyse the results of the surgical treatment of coexisting cataract and glaucoma and its effects on corneal endothelial cell density (CECD). Methods We include two longitudinal prospective studies: one randomised that included 40 eyes with open angle glaucoma that received one- (n = 20) or two-step (n = 20) phacotrabeculectomy and another that included 20 eyes that received phacoemulsification. We assess the impact of surgery on different clinical variables and in particular in CECD using Confoscan 4™ confocal microscopy and semiautomatic counting methods. Results Phacoemulsification and phacotrabeculectomy, but not trabeculectomy, increase significantly best-corrected visual acuity and anterior chamber depth and trabeculectomy and one- or two-step phacotrabeculectomy decreased similarly the intraocular pressure. We document percentages of endothelial cell loss of 3.1%, 17.9%, 31.6% and 42.6% after trabeculectomy, phacoemulsification and one- or two-step phacotrabeculectomy, respectively. The coefficient of variation did not increase significantly after surgery but the percentage of hexagonality decreased significantly after phacoemulsification and after two-step phacotrabeculectomy. Conclusions Trabeculectomy, phacoemulsification and phacotrabeculectomy are surgical techniques that cause morphological changes and decrease the densities of the corneal endothelial cells. Trabeculectomy produces lesser endothelial cell loss than phacoemulsification, and phacoemulsification lesser cell loss than phacotrabeculectomy. Two-step phacotrabeculectomy (trabeculectomy followed 3 months later by phacoemulsification) causes more cell loss than one-step phacotrabeculectomy, and this could be due to the cumulative effects of two separate surgical traumas or to a negative conditioning lesion effect of the first surgery. For the treatment of coexisting glaucoma and cataract, one-step phacotrabeculectomy is the treatment of choice.

show abstract

“…The percentage of corneal endothelial cell density (ECD) loss after trabeculectomy ranged from 3.2% to 18.2% (Kim et al, 2016; Lee et al 2017; Arimura et al 2018; Hirooka et al, 2019). Furthermore, previous studies reported that the risk factors for corneal ECD loss after trabeculectomy are mitomycin C, older age, uveitic glaucoma and exfoliation glaucoma (Zarei et al 2015; Hirooka et al, 2019; Higashide et al; 2019). The present study aimed to evaluate the long‐term changes in corneal ECD loss after trabeculectomy and identify the risk factors for corneal ECD loss.…”

Section: Characteristics Total (N = 81) Trab‐alone (N = 65) Trab‐phaco (N = 16) P‐valuementioning

confidence: 99%