Corneal endothelial changes after subscleral trabeculectomy with mitomycin-C

• Main Authors: Faried M Wagdy, Adel G Zaky, Sara N.A Gohar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Delta Journal of Ophthalmology
• Subjects: changes; corneal; endothelial; mitomycin-c; subscleral trabeculectomy
• Online Access: http://www.djo.eg.net/article.asp?issn=1110-9173;year=2019;volume=20;issue=2;spage=63;epage=67;aulast=Wagdy

Background Antimetabolites have been proposed to increase the success rate and reduce fibrosis associated with filtering surgery. However, they have cytotoxic effect on corneal endothelial cells. Noncontact specular microscopy was used for measuring the endothelial cell changes after subscleral trabeculectomy (Trab) with antimetabolites. Purpose The aim of this study was to evaluate the changes that occur in corneal endothelial cells after subscleral Trab with mitomycin-C (MMC). Patients and methods This is a prospective interventional study that was carried out on 30 eyes of 26 patients attending the Ophthalmology Department of Menoufia University Hospitals. They were prepared for subscleral Trab with MMC in the period between April 2017 and April 2018. Follow-up for those patients was done by specular microscopy preoperatively and 1 week, 3, and 6 months postoperatively to evaluate corneal endothelial changes. Specular microscopy was performed at the Memorial Institute of Ophthalmology in Giza. Results There was a significant decrease in cell density but nonsignificant difference in central corneal thickness and cell size 6 months after surgery compared with preoperative values. Intraocular pressure was controlled after surgery and remained low during the follow-up period. Conclusion Subscleral Trab with MMC caused a significant but nonclinically remarkable loss of endothelial cells which occurred only intraoperatively or at the early postoperative period. However, prolonged toxic effect of MMC and progressive cell loss were not a major concern.