Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma

Eye (Lond). 2014 Jan;28(1):47-52. doi: 10.1038/eye.2013.231. Epub 2013 Oct 18.


Purpose: To investigate the changes in endothelial cell count, central corneal thickness (CCT), and refractive error after a session of selective laser trabeculoplasty (SLT) for open angle glaucoma (OAG).

Methods: This prospective cohort study recruited 111 eyes of 66 consecutive subjects with OAG. Subjects received SLT to 360° of the trabecular meshwork. Endothelial cell count, CCT, and spherical equivalent were measured at baseline before SLT as well as at 1 week and 1 month post SLT. A repeated measure nested ANOVA with Tukey's multiple comparison test was performed to compare the outcome measures before and after SLT.

Results: In 111 eyes of 66 subjects, the mean number of laser applications per treatment was 166.9 ± 41.4 with a mean energy level of 1.0 ± 0.07 mJ. The mean endothelial cell count decreased significantly from 2465.0 ± 334.0 cells/mm(2) at baseline to 2355.0 ± 387.0 cells/mm(2) at 1 week (P=0.0004) but increased to baseline levels at 1 month post SLT (2424.0 ± 379.4 cells/mm(2), P=0.3). The CCT, which decreased from a baseline of 549.4 ± 37.6 to 543.9 ± 40.2 μm at 1 week post SLT (P=0.02), also returned to the baseline level by 1 month (P=0.2). The spherical equivalent was static from baseline. A positive correlation was found between total laser energy and CCT at 1 month post treatment (r=0.3, P=0.005).

Conclusion: The transient reductions in endothelial cell count and CCT following SLT returned to baseline levels 1 month after the procedure. Patients undergoing SLT should be aware of the risk of potential corneal changes.

MeSH terms

  • Cell Count
  • Cohort Studies
  • Corneal Endothelial Cell Loss / etiology*
  • Corneal Endothelial Cell Loss / physiopathology
  • Corneal Pachymetry
  • Endothelium, Corneal / pathology*
  • Female
  • Glaucoma, Open-Angle / physiopathology
  • Glaucoma, Open-Angle / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Laser Therapy / adverse effects*
  • Male
  • Middle Aged
  • Prospective Studies
  • Tomography, Optical Coherence
  • Trabecular Meshwork / physiopathology
  • Trabecular Meshwork / surgery*
  • Trabeculectomy / adverse effects*
  • Visual Acuity / physiology