Tsontcho Ianchulev1, Stephen Lane2,3, Marisse Masis4, Jonathan H Lass5,6, Beth Ann Benetz5,6, Harry J Menegay5,6, Francis W Price7, Shan Lin4. 1. New York Eye and Ear Infirmary of Mount Sinai, New York, NY. 2. Alcon, Fort Worth, TX. 3. Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota. 4. University of California San Francisco, San Francisco, CA. 5. Cornea Image Analysis Reading Center, University Hospitals Eye Institute, Cleveland, OH. 6. Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH. 7. Cornea Research Foundation of America, Indianapolis, IN.
Abstract
PURPOSE: To evaluate corneal endothelial cell density (ECD) and morphology 2 years after phacoemulsification in subjects from the COMPASS trial (ClinicalTrials.gov, NCT01085357) who had mild-to-moderate primary open-angle glaucoma and visually significant cataracts. METHODS: The central corneal endothelium was evaluated by serial specular microscopy at 0 to 24 months. ECD, coefficient of variation, and percentage of hexagonal cells were evaluated by a central image analysis reading center and central corneal thickness (CCT) was evaluated by ultrasound pachymetry. RESULTS: Of 131 subjects who underwent routine phacoemulsification, analyzable endothelial images at 24 months were available for 126 subjects (96.2%). Mean ±SD central ECD at baseline was 2453 ± 359 cells/mm, decreasing by 10% ± 14% to 2195 ± 517 cells/mm at 3 months (P < 0.001) but stabilizing thereafter with mean endothelial cell loss (ECL) from baseline to 24 months of 9% ± 13% (P < 0.001). Twelve (9.5%) and 10 (7.9%) subjects experienced >30% ECL at 12 and 24 months, respectively. Neither coefficient of variation nor percentage of hexagonal cells changed significantly from baseline at any time point. Mean CCT was similar at baseline (550 ± 35 μm) and at 12 months (551 ± 37 μm) and 24 months (555 ± 35 μm). Age was significantly associated with ECLafter cataract surgery (P = 0.02), but baseline intraocular pressure, number of glaucoma medications, and CCT were not. Similar results were observed in patients who underwent CyPass micro-stent implantation accompanying phacoemulsification. CONCLUSIONS:Phacoemulsification in eyes with mild-to-moderate primary open-angle glaucoma results in early ECL, with ECD stabilizing after 3 months and no effect on other endothelial stress markers up to 2 years postoperatively.
RCT Entities:
PURPOSE: To evaluate corneal endothelial cell density (ECD) and morphology 2 years after phacoemulsification in subjects from the COMPASS trial (ClinicalTrials.gov, NCT01085357) who had mild-to-moderate primary open-angle glaucoma and visually significant cataracts. METHODS: The central corneal endothelium was evaluated by serial specular microscopy at 0 to 24 months. ECD, coefficient of variation, and percentage of hexagonal cells were evaluated by a central image analysis reading center and central corneal thickness (CCT) was evaluated by ultrasound pachymetry. RESULTS: Of 131 subjects who underwent routine phacoemulsification, analyzable endothelial images at 24 months were available for 126 subjects (96.2%). Mean ± SD central ECD at baseline was 2453 ± 359 cells/mm, decreasing by 10% ± 14% to 2195 ± 517 cells/mm at 3 months (P < 0.001) but stabilizing thereafter with mean endothelial cell loss (ECL) from baseline to 24 months of 9% ± 13% (P < 0.001). Twelve (9.5%) and 10 (7.9%) subjects experienced >30% ECL at 12 and 24 months, respectively. Neither coefficient of variation nor percentage of hexagonal cells changed significantly from baseline at any time point. Mean CCT was similar at baseline (550 ± 35 μm) and at 12 months (551 ± 37 μm) and 24 months (555 ± 35 μm). Age was significantly associated with ECL after cataract surgery (P = 0.02), but baseline intraocular pressure, number of glaucoma medications, and CCT were not. Similar results were observed in patients who underwent CyPass micro-stent implantation accompanying phacoemulsification. CONCLUSIONS: Phacoemulsification in eyes with mild-to-moderate primary open-angle glaucoma results in early ECL, with ECD stabilizing after 3 months and no effect on other endothelial stress markers up to 2 years postoperatively.
Authors: Bradley Beatson; Jiangxia Wang; Michael V Boland; Pradeep Ramulu; Oliver Schein; Michael J Fliotsos; Michael E Sulewski; Divya Srikumaran Journal: Am J Ophthalmol Date: 2022-01-05 Impact factor: 5.488
Authors: Philippe Denis; Christoph Hirneiß; Georges M Durr; Kasu Prasad Reddy; Anita Kamarthy; Ernesto Calvo; Zubair Hussain; Iqbal K Ahmed Journal: Br J Ophthalmol Date: 2020-10-03 Impact factor: 4.638