Dataset Information

Corneal endothelial cell density loss following glaucoma surgery alone or in combination with cataract surgery: a systematic review protocol.

ABSTRACT:

Objective

We aim to systematically assess and compare corneal endothelial cell density (ECD) loss in patients with glaucoma following glaucoma surgery and cataract surgery.

Introduction

Corneal ECD loss may occur due to intraoperative surgical trauma in glaucoma surgery or postoperatively with chronic endothelial cell trauma or irritation. Corneal oedema and decompensation after aqueous shunt glaucoma surgery has been reported but the long-term ECD loss is still unknown.

Inclusion criteria

Trabeculectomy, glaucoma filtration surgery or microinvasive glaucoma surgery in adults with ocular hypertension, primary and secondary open angle glaucoma, normal tension glaucoma and angle-closure glaucoma. Participants with pre-existing corneal disease will be excluded. Glaucoma laser treatments and peripheral iridotomy will be excluded. The outcomes include preoperative and postoperative corneal ECD, percentage change of corneal ECD and adverse events.

Methods

We will conduct an electronic database search for randomised controlled trials, prospective non-randomised studies, observational studies in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and The International Prospective Register of Systematic Reviews (PROSPERO). Eligibility criteria will include quantitative articles published after and including the year 2000, written in English and containing data on ECD loss. Two independent reviewers will screen titles and abstracts and extract data from full texts, reporting outcomes according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction of key characteristics will be completed using customised forms. Methodological quality will be assessed using the Joanna Briggs Institute critical appraisal forms.

Ethics and dissemination

Ethics approval is not required for this review, as it will only include published data. Findings will be published in a peer-reviewed journal and disseminated across ophthalmic networks.

Prospero registration number

PROSPERO CRD42020192303.

SUBMITTER: Fang CEH

PROVIDER: S-EPMC8438923 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Similar Datasets

Project description:PURPOSE:To evaluate corneal endothelial cell loss after Baerveldt glaucoma implantation. METHODS:We prospectively evaluated changes in endothelial cell density (ECD) in the cornea of 59 patients (59 eyes) who underwent Baerveldt glaucoma implantation. Tubes were inserted into the anterior chamber in 45 eyes and pars plana in 14 eyes. The primary outcome measure was the change in corneal ECD after Baerveldt glaucoma implantation. Secondary outcome measures included relationships between corneal ECD and optical coherence tomography images of tube parameters (tube-cornea distance and tube-cornea angle) and prognostic factors for corneal ECD loss. RESULTS:Corneal ECD decreased significantly by 9.2% at 12 months after surgery (P = 0.001). In the anterior chamber Baerveldt glaucoma implantation group, corneal ECD at the tube insertion quadrant decreased significantly by 9.6% at 3 months (P = <0.001), 10.7% at 6 months (P = <0.001), and 13.1% at 12 months (P = <0.001). Corneal ECD at the center decreased significantly at 6 months after surgery (7.2% loss; P = 0.012) and at 12 months after surgery (12.1% loss; P = 0.001). Corneal ECD at the contralateral quadrant decreased significantly at 12 months after surgery only (10.3% loss; P = 0.004). In the pars plana Baerveldt glaucoma implantation group, no significant loss of corneal ECD was found in any corneal areas at any post-surgery follow-up visits. Tube-cornea angle was negatively correlated with the rate of corneal ECD loss at the tube insertion quadrant; r = -0.55 (P = 0.0013). In multivariable analyses, exfoliation glaucoma and narrower tube-cornea angle were significant prognostic factors for severe corneal ECD loss (P = 0.0068 and P = 0.046, respectively). CONCLUSIONS:Anterior chamber Baerveldt glaucoma implantation causes corneal endothelial cell loss. Corneal endothelial cell loss starts at the tube insertion quadrant. Exfoliation glaucoma and narrower tube-corneal angle are associated with severe loss of corneal endothelial cells.