Evaluation of corneal endothelial changes in Glaucomatous eyes undergoing trabeculectomy: a hospital based prospective study in north India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 6
Abstract
Introduction: Glaucoma is a disease in which a progressive loss of retinal ganglion cells is characterized by a recognizable pattern of both visual function loss & optic nerve pallor and excavation. Medical management of glaucoma has many drawbacks like lack of compliance by the patients, high cost factor, toxicity of drugs, drug resistance, continued loss of visual acuity and field despite adequate control of IOP and failure of regular follow-up visits. Glaucoma patient have decreased mean endothelial cell density. Corneal endothelial cell count has been shown to be further reduced after glaucoma filtration surgery. Decrease in endothelial cell count depends on no of factors like type of Glaucoma, Intraoperative use of mitomycin-C, post-op shallowing of anterior chamber. Objective: To quantify changes in corneal endothelial cell count, central corneal thickness and structural changes like pleomorphism/polymegathism in patients undergoing trabeculectomy.. Material & Methods: Trabeculectomy was carried in 30 patients of Primary Open/Closed angle Glaucoma using standard technique. Pre-operatively and post-operatively at 01 & 06 weeks patients were evaluated by Specular microscopy, Pachymetry, IOP and best corrected visual acuity. Intra-operative Mitomycin-C in standard concentration was used in 11 patients with standard post-operative treatment regimen followed . Results: There was no statistically significant difference in cell count or pachymetry value change at 1 or 6 week post-operatively with a P value of > 0.05. No significant change in cell size (Polymegathism) or shape (Pleomorphism) was noted post-operatively. The IOP was well controlled in all patients post-operatively. Shallowing of anterior chamber was noted on 1st post-operative day in 3 patients (27%) whom Mitomycin-C was used which improved over next 2-3 days with conservative management without significant endothelial cell loss. Conclusion: Corneal endothelial cell density do decreases after Trabeculectomy like other intra-ocular surgical procedures. But there is no significant decrease in endothelial cell count or significant change in corneal thickness following Trabeculectomy when there is no prolonged shallowing of anterior chamber.
Authors and Affiliations
Lt Col (Dr) Ashok Kumar, Brig (Dr) Poninder Kumar, Col (Dr) Vinod Kumar Baranwal
Keywords
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- EP ID EP376060
- DOI 10.9790/0853-1706062629.
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