Effect of trabeculectomy on corneal endothelial cell loss

Br J Ophthalmol. 2020 Mar;104(3):376-380. doi: 10.1136/bjophthalmol-2018-313417. Epub 2019 Jun 14.


Aim: To investigate changes in corneal endothelial cell density (CECD) after trabeculectomy.

Methods: This prospective, observational study followed 117 eyes of 117 patients for 2 years after trabeculectomy. The central cornea was examined by corneal specular microscopy prior to and at every 6 months after the surgery. Survival analysis of patients who exhibited a 10% or less reduction of the postoperative CECD compared with preoperative levels was assessed using the Kaplan-Meier survival curve. A Cox proportional hazards model was used to evaluate prognostic factors for decreasing CECD.

Results: At baseline, the mean CECD was 2420±357 cells/mm2, while at 6, 12, 18 and 24 months after surgery, the mean CECD was 2324±373 cells/mm2 (p<0.001), 2276±400 cells/mm2 (p<0.001), 2290±398 cells/mm2 (p<0.001) and 2267±446 cells/mm2 (p<0.001), respectively. At 6, 12, 18 and 24 months after surgery, the results of the Kaplan-Meier survival analysis of the 10% loss of CECD from baseline were 91%, 85%, 83% and 77%, respectively. Uveitic glaucoma was a significant prognostic factor for decreasing CECD (p=0.041).

Conclusions: CECD significantly and continuously decreased after trabeculectomy.

Keywords: cornea; glaucoma; treatment surgery.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cell Count
  • Corneal Endothelial Cell Loss / diagnosis*
  • Corneal Endothelial Cell Loss / etiology
  • Endothelium, Corneal / pathology*
  • Female
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Postoperative Complications*
  • Prognosis
  • Retrospective Studies
  • Trabeculectomy / adverse effects*
  • Visual Acuity*