After investigating factors associated with decreased corneal endothelial cell density (ECD) after trabeculectomy with mitomycin C, a team of Japanese researchers found that the type of glaucoma and older age were risk factors for larger ECD decrease.

This retrospective study evaluated 162 eyes of 136 patients with primary open angle glaucoma (POAG), exfoliation glaucoma, neovascular glaucoma or uveitic glaucoma who underwent trabeculectomy. The researchers then compared postoperative and preoperative ECD and analyzed risk factors for decrease.

The team found that mean intraocular pressure decreased from 25.3 ±9.6mm Hg to 9.2±2.3mm Hg postoperatively. They note that the mean ECD decrease at 24 months was 9.3% in all cases; it was 18.2% in eyes with exfoliative glaucoma and 20.6% in uveitic glaucoma, both significantly greater than the 4.8% in eyes with POAG.

The study concludes that having exfoliative or uveitic glaucoma and being of older age were significantly associated with larger ECD decrease. In addition, preoperative use of oral carbonic anhydrase inhibitors, history of vitrectomy and postoperative choroidal detachment were significantly associated with a declining ECD trend over time.

Higashide T, Nishino T, Sakaguchi K, et al. Determinants of corneal endothelial cell loss after trabeculectomy with mitomycin C. J Glaucoma. October 11, 2018. [Epub ahead of print].