Corneal Endothelial cell changes after sub scleral Trabeculectomy in glaucoma patients

Abstract

Abstract Background: About 1% of the population over the age of 40 develops glaucoma, making it the most common cause of irreversible blindness. Seventy-four per cent of all glaucoma cases are primary open-angle glaucoma. Trabeculectomy is a form of modern filtration surgery used to lower intraocular pressure in a glaucoma patient. Aim of the Work: evaluation of corneal endothelial cells changes before and after sub scleral trabeculectomy using specular microscopy. Patients and Methods: Our study was a prospective non-randomized study of 20 glaucomatous patients managed by trabeculectomy with Mitomycin C, the study included patients above the age of 40 years with open angle glaucoma that failed to be controlled by medical treatment. We compared the preoperative and postoperative central corneal endothelial cell density (ECD), endothelial cell coefficient of variation (CV), Hexagonal cell percentage, corneal thickness, best-corrected visual acuity, and intraocular pressure (IOP). Results: our study revealed a highly significant decrease in central corneal endothelial cell count following trabeculectomy, the suggested mechanisms may be the toxic effect of MMC, increased manipulation in the anterior chamber during surgery and fluctuation of IOP following surgery Conclusion: According to our findings, the central corneal thickness hardly budges after trabeculectomy, and the fraction of hexagonal cells decreases.