Changes in corneal endothelial cells after Ahmed glaucoma valve implantation: 2-year follow-up.
OBJECTIVE
To evaluate changes in corneal endothelial cells after Ahmed glaucoma valve (AGV) implantation for the treatment of refractory glaucoma.


METHODS
Observational case series.


METHODS
We prospectively evaluated the change in density and shape of the corneal endothelium in 41 patients (41 eyes) who had undergone AGV implantation for the treatment of refractory glaucoma. Corneal specular microscopy was performed on the superior, supratemporal, supranasal, and central areas with a noncontact specular microscope before surgery and 1, 6, 12, 18, and 24 months after surgery. The changes at each time point were compared with those at baseline and with those of the control group, which consisted of 20 contralateral glaucomatous eyes receiving antiglaucoma medications.


RESULTS
The mean follow-up was 19.1 months. The average percentage decrease in corneal endothelial cell count was 5.8% at 1 month, 11.5% at 6 months, 15.3% at 12 months, 16.6% at 18 months, and 18.6% at 24 months after surgery. The changes were statistically significant compared with those at baseline and those of the control eye at all time points during the study period (P < .05). The supratemporal area, the closest site to the tube, showed the greatest decrease in endothelial cell density, by 22.6%, whereas the central cornea showed the smallest decrease, by 15.4%, at 24 months after surgery.


CONCLUSIONS
There was statistically significant corneal endothelial cell loss in the operated eye after AGV implant surgery. The corneal endothelial cell loss increased with time: 15.3% at 12 months and 18.6% at 24 months after surgery, on average, in all measured areas.
Lee
Eun-Kyoung
EK
Department of Ophthalmology, College of Medicine, Chungnam National University, Daejeon, Korea.
Yun
Yong-Jun
YJ
Lee
Jong-Eun
JE
Yim
Jin-Ho
JH
Kim
Chang-Sik
CS
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002452:Cell Count; D048430:Cell Shape; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D020327:Glaucoma Drainage Implants; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation; D014065:Tonometry, Ocular
D000959:Antihypertensive Agents