Objective: To evaluate the safety of trabeculotome tunnelling trabeculoplasty (3T) in treating primary open-angle glaucoma (POAG) by observing the changes in corneal endothelial cell quantity and morphology after surgery. Methods: This was a retrospective case series study. Patients diagnosed with POAG who underwent successful 3T surgery were recruited from the Department of Ophthalmology, Chengdu First People's Hospital between April 2023 and September 2025. Parameters such as the number of cells, corneal endothelial cell density, average size, hexagonal cell ratio of endothelial cells, and central corneal thickness were recorded preoperatively and at 6 months postoperatively. Data were analyzed using the t-test. Results: The cohort comprised 48 patients, involving 52 eyes (27 left eyes, 25 right eyes), of whom 36 (75%) were male and 12 (25%) were female. The mean age of the patients was (51.37±12.90) years, ranging from 18 to 72 years. The preoperative number of cells was (196±40) cells, which decreased to (170±56) cells at 6 months postoperatively (P<0.05). The preoperative endothelial cell density was (2 686±416) cells/mm², compared to (2 302±563) cells/mm² at 6 months postoperatively (P<0.05). The average size increased from (381±76) μm² preoperatively to (470±161) μm² at 6 months postoperatively (P<0.05). The hexagonal cell ratio was (52±9)% preoperatively and (50±8)% at 6 months postoperatively, with no significant difference (P>0.05). The central corneal thickness was (517±49) μm preoperatively and (514±39) μm at 6 months postoperatively, with no significant difference (P>0.05). Conclusions: Although the 3T surgery for POAG results in a slight reduction in corneal endothelial cell count, as well as changes in corneal endothelial cell morphology and size, it does not induce corneal endothelial decompensation during the 6-month follow-up period and shows favorable short-term safety.
目的： 探讨新型微创内路三联（3T）手术治疗原发性开角型青光眼（POAG）对角膜内皮细胞的安全性。 方法： 回顾性病例系列研究。纳入2023年4月至2025年9月期间在成都市第一人民医院眼科确诊为POAG并接受3T手术患者的病例资料。对比患者术前及术后6个月的角膜内皮细胞数量（NUM）、角膜内皮细胞密度（ECD）、平均细胞大小（AVG）、六边形比率（HEX），中央角膜厚度（CCT）。采用配对样本t检验进行统计分析。 结果： 共纳入患者48例（52只眼），其中27只左眼，25只右眼；女性12例（25%），男性36例（75%）；年龄为（51.37±12.90）岁，年龄范围为18~72岁。术前NUM为（196±40）个，术后6个月为（170±56）个；术前ECD为（2 686±416）个/mm2，术后6个月为（2 302±563）个/mm2；术前AVG为（381±76）μm2，术后6个月为（470±161）μm2；术前与术后6个月相比，差异均有统计学意义（均P<0.05）。术前HEX为52%±9%，术后为50%±8%；术前CCT为（517±49）μm，术后6个月为（514±39）μm；术前与术后6个月相比，差异均无统计学意义（均P>0.05）。 结论： 3T手术治疗POAG虽会造成角膜内皮细胞数量轻微减少，形态和大小有所改变，但术后6个月未引发角膜内皮功能失代偿，短期安全性良好。.