Corneal endothelial cell loss after Baerveldt glaucoma drainage device implantation in the anterior chamber

Annelie N Tan, Carroll A B Webers, Tos T J M Berendschot, John de Brabander, Pauline M de Witte, Rudy M M A Nuijts, Johannes S A G Schouten, Henny J M Beckers

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: To investigate central and peripheral corneal endothelial cell density (ECD) in relation to Baerveldt (BV) glaucoma drainage device (GDD) tube corneal (TC) distance.

METHODS: Prospective study of all patients scheduled for glaucoma tube surgery with 36 months follow-up. A BV GDD was inserted into the anterior chamber (AC). Anterior segment optical coherence tomography (AS-OCT) scans were made to determine the TC distance. Central and peripheral ECD was measured, preoperatively and at 3, 6, 12, 24 and 36 months postoperatively.

RESULTS: Fifty-three eyes were included [primary open-angle glaucoma, (n = 13); secondary glaucoma, (n = 30); and primary angle-closure glaucoma, (n = 10)]. Central ECD significantly decreased during follow-up, with a mean decrease of 4.54% per year (p < 0.001), and 6.57% in the peripheral quadrant closest to the BV GDD tube (PQC, p < 0.001). In the PQC, a yearly decrease of 1.57% was shown after transiridial tube placement versus 7.43% after placement 'free' into the AC (p = 0.006). Endothelial cell (EC) loss was related to TC distance (mean 1.69 mm), with a central loss of 6.20% and 7.25% in the PQC per year with shorter TC distances, versus a central loss of 4.11% and 5.77% in the PQC per year with longer TC distances (outside mean ± 2SD, p < 0.001). A difference in EC loss by glaucoma subtype was not identified.

CONCLUSION: The TC distance is of significant influence on corneal ECD, a shorter TC distance causing more severe EC loss, especially in the PQC. Transiridial placement of the BV GDD tube seems safer than placement 'free' into the AC.

Original languageEnglish
Pages (from-to)91-96
Number of pages6
JournalActa Ophthalmologica
Volume95
Issue number1
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Aged
  • Anterior Chamber
  • Corneal Endothelial Cell Loss
  • Female
  • Glaucoma Drainage Implants
  • Glaucoma, Angle-Closure
  • Glaucoma, Open-Angle
  • Humans
  • Intraocular Pressure
  • Intubation
  • Middle Aged
  • Prospective Studies
  • Prosthesis Implantation
  • Tomography, Optical Coherence
  • Journal Article
  • ATTENTION
  • VISION
  • anterior segment OCT
  • glaucoma
  • MICROSACCADES
  • RETINAL IMAGE
  • FIXATION
  • SACCADIC EYE-MOVEMENTS
  • VISUAL-PERCEPTION
  • AMBLYOPIA
  • corneal endothelial cell loss
  • glaucoma drainage implants

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