The effect of combined phacotrabeculectomy, trabeculectomy and phacoemulsification on the corneal endothelium in the early stage: a preliminary study

Abstract

Purpose: We aimed to investigate the effect of combined phacotrabeculectomy, trabeculectomy and phacoemulsification on the corneal endothelium in the early stage. Materials and methods: In this prospective and non-randomized study, three groups were identified each consisting of 20 eyes (Group I phacotrabeculectomy, group II trabeculectomy, group III phacoemulsification). In the pre- and postop month 1, corneal endothelial cell density (CECD), coefficient of variation (CV) (polymegathism) and hexagonality (Hex) (pleomorphism) were measured by means of a non-contact specular microscope (Nidek CEM-530, NIDEK Co., Ltd. Japan). Results: The postop CECD in each of the three groups showed a significant decrease when compared with the preop period (6.1% in the phacotrabeculectomy group, 4.9% in the trabeculectomy group and 7.4% in the phacoemulsification group). The amount of decrease in the preop and postop CECD values showed no significant difference among these three groups. The postop CV value in each of the three groups showed a significant increase when compared with the preop period. The postop Hex value in each of the three groups showed no significant change when compared with the preop period. Conclusion: In our study, we observed that performing a combined phacotrabeculectomy on patients with glaucoma and cataract association in the same session did not do more harm to the corneal endothelium than other surgical methods. For this reason, this method can be applied safely to a patient population that is likely to develop corneal decompensation.