A comparison of corneal endothelial cell changes after 1-site and 2-site phacotrabeculectomy.
OBJECTIVE
To compare the corneal endothelial cell (CEC) changes that occurred after phacotrabeculectomy performed at 1 or 2 sites.


METHODS
A historical cohort study.


METHODS
The records of patients who had 1-site (n = 61) or 2-site (n = 52) limbus-based phacotrabeculectomy over a 4-year period (2002-2005) at 1 eye surgery center (Vanak Eye Surgery Center, Tehran, Iran) by a single surgeon were reviewed, and postoperative CEC indices were measured. Preoperative CEC indices, performed for a then-ongoing trial, were compared with postoperative measurements of the last follow-ups. The main outcome measure was endothelial cell count.


RESULTS
The median follow-up time was 12 months (range 9-24 months). There was no difference between the operations in improving visual acuity, lowering intraocular pressure, and decreasing the number of antiglaucoma medications required. However, 2-site surgery was associated with significantly more expansion in the CEC area (P < 0.001). On multivariate analysis, longer follow-up, 2-site surgery, and grade 4 cataract density were independently associated with more CEC loss, and longer follow-up, 2-site surgery, and steroid-induced glaucoma were associated with CEC area expansion. Postoperative complications were not markedly different between the 2 groups.


CONCLUSIONS
In both groups, the longer the follow-up time was, the higher the CEC loss and the CEC area expansion were. One-site surgery seems to cause less CEC damage than the 2-site operation during the median follow-up time of 1 year.
Nassiri
Nader
N
Department of Ophthalmology, Imam Hossein Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. drnassirin@sbmu.ac.ir
Nassiri
Nariman
N
Rahnavardi
Mohammad
M
Rahmani
Laleh
L
D000368:Aged; D002386:Cataract / Q000150:complications / Q000628:therapy*; D002452:Cell Count; D015331:Cohort Studies; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D014130:Trabeculectomy / Q000009:adverse effects* / Q000379:methods; D014792:Visual Acuity