Study: One-site phacotrabeculectomy has less corneal endothelial cell damage than two-site

Performing one-site phacotrabeculectomy appears to cause less corneal endothelial cell damage than two-site phacotrabeculectomy, a study found.

"In both groups, the longer the follow-up time was, the higher the [corneal endothelial cell] loss and the [corneal endothelial cell] area expansion were," the study authors said in the September issue of Cornea.

Nader Nassiri, MD, and colleagues compared corneal endothelial cell changes after one-site phacotrabeculectomy was performed on 61 patients and two-site phacotrabeculectomy was performed on 52 patients between 2002 and 2005 at Vanak Eye Surgery Center in Tehran, Iran. Specifically, the investigators measured and compared preoperative and postoperative corneal endothelial cell indices.

Median follow-up was 12 months, ranging from 9 months to 24 months.

The investigators reported no significant differences between the two procedures concerning their influence on visual acuity improvement, IOP reduction and reduction of antiglaucoma medications required.

However, they found a significant link between two-site surgery and increased corneal endothelial cell area expansion (P < .001).

According to multivariate analysis, longer follow-up, two-site surgery and grade four cataract density were independent risk factors for more corneal endothelial cell loss.

In addition, the investigators found an association between longer follow-up, two-site surgery, steroid-induced glaucoma and corneal endothelial cell area expansion.

Postoperative complications were comparable for both groups, according to the study.