Acute transient corneal endothelial changes following selective laser trabeculoplasty.
BACKGROUND
To report for the first time acute transient corneal endothelial changes following selective laser trabeculoplasty.


METHODS
Observational case series at a tertiary referral ophthalmological centre in the United Kingdom (Addenbrooke's Hospital, Cambridge)


METHODS
Ten consecutive routinely treated patients.


METHODS
Baseline measurements of corneal specular microscopy, endothelial cell counts and in vivo confocal microscopy were performed prior to routine selective laser trabeculoplasty treatment. Repeat measurements were made approximately 1 h later and at a 6-week follow up.


METHODS
Endothelial in vitro laser confocal microscopy, specular microscopic endothelial cell count, endothelial morphology, visual acuity and intraocular pressure.


RESULTS
All patients had normal corneal endothelia prior to routine selective laser trabeculoplasty treatment, where 180 degrees of angle was treated. Approximately an hour afterwards, nearly all patients still had normal specular microscopy and cell counts (2237 ± 211 cells/mm(2) ) but had subtle endothelial changes on slit-lamp examination. These changes were found diffusely across the cornea. The changes were not present at the 6-week follow up and cell counts remained unchanged (2278 ± 242 cells/mm(2) ). Acuity remained unchanged throughout and the patients were not aware of these changes subjectively.


CONCLUSIONS
Selective laser trabeculoplasty appears to cause transient corneal endothelial changes in most patients that have no impact on cell count or visual acuity. Further work is required to elucidate the mechanism of this phenomenon and any long-term impact.
NIHR Biomedical Research Centre, University of Cambridge, UK. andrew.white@sydney.edu.au
Andrew J R
AJ
White
Achyut
A
Mukherjee
Inderraj
I
Hanspal
Nicholas J
NJ
Sarkies
Keith R
KR
Martin
Peter
P
Shah
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003316:Corneal Diseases / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D053844:Lasers, Solid-State / Q000009:adverse effects*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009798:Ocular Hypertension / Q000601:surgery; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity / Q000502:physiology