Title: Implications of Glaucoma Management on Corneal Endothelial Cell Density - Two Edged Sword
Authors: Dr Preeti Rawat, Dr Varun Upadhyay , Dr V Bhaisare, Dr S. Walia, Dr Neetu Kori
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.23
Abstract
Purpose: To study the effect of glaucoma management on corneal endothelial cell density.
Method: Our study included 112 eyes of 65 diagnosed cases of glaucoma of same age group who underwent visual acuity test, IOP measurement, Gonioscopy, Fundus examination and specular microscopy analysis. Exclusion criteria included history of corneal disease, diabetes mellitus, any ocular inflammation, trauma or surgery other than peripheral iridectomy.
Observations and Results: Patients who underwent PI or Trabeculectomy were found to have significantly lower cell density (2080 +263 cells/mm2)than those without any surgical or laser intervention (2474 + 362 cells/mm2) (p=0.000). Although statistically insignificant, but patients on 3 or 4 anti glaucoma medications were having lower cell density than those on 1 or 2 medication.
Conclusion: In our study it is evident that cell density is lower in glaucoma patients than those without glaucoma. This may be proposed to direct damage from high IOP, post trabeculectomy or iridectomy cell loss, medication toxicity or combination of these. So while achieving target pressure benefit- risk ratio of endothelial cell density decompensation should be mandatorily considered.
Keywords: Glaucoma, Endothelial cell density, laser PI, Trabeculectomy.
