Study: More corneal endothelial cell loss from trabeculectomy vs. deep sclerectomy

Both trabeculectomy and deep sclerectomy can lead to significant corneal endothelial cell loss postoperatively, a prospective study found. However, cell loss was greater in trabeculectomy-treated eyes, which suggests that deep sclerectomy causes less corneal damage, the study authors said.

Stephane Arnavielle, MD, and colleagues in France compared the effects of the two glaucoma surgeries in 62 eyes of 62 patients. Surgeons performed trabeculectomy alone in 18 eyes, deep sclerectomy alone in 14 eyes, combined trabeculectomy and phacoemulsification in 11 eyes and combined deep sclerectomy and phacoemulsification in 19 eyes.

Using noncontact specular microscopy, the researchers found a significant reduction in central cornea endothelial cells at 3 months and 1 year follow-up, regardless of whether surgery was combined with phacoemulsification. However, endothelial cell counts decreased significantly more after penetrating surgeries and averaged 7% compared with 2.6% after nonpenetrating surgery, according to the study.

Cell loss in the upper cornea was also significantly higher after trabeculectomy, but only in noncombined surgery, the authors noted.

The study is published in the May issue of Journal of Glaucoma.