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Factors influencing the reduction in corneal endothelial cells after Ex-Press® surgery

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ARTICLE DOWNLOAD

Factors influencing the reduction in corneal endothelial cells after Ex-Press® surgery

5$

Naoki Tojo, Ayaka Numata & Atsushi Hayashi 

Abstract

Purpose

We investigated the factors that influence the reduction in corneal endothelial cells after Ex-Press® surgery.

Methods

This was a retrospective study. We included patients who had undergone Ex-Press surgery and were followed up for > 2. We analyzed the corneal endothelial cell density (ECD) before and after Ex-Press surgery. We investigated the insertion position (Ex-Press device was inserted into cornea or trabecular meshwork (TM)), Ex-Press–iris touch, cornea–iris touch, peripheral anterior synechiae, history of trabeculotomy, history of selective laser trabeculoplasty, type of glaucoma, and simultaneous cataract surgery as influencing factors. We used multivariate analysis to determine the factors influencing the reduction rate of ECD.

Results

We included 129 eyes. The mean of ECD had decreased 7.0% at 2 years. Ex-Press surgeries significantly decreased the ECD after 2 years (p = 0.0118). As a result of the multivariate analysis, the factor that led to a significantly faster reduction in ECD was the insertion position of the Ex-Press (p < 0.0001). The reduction rate of ECD after 2 years in cases of insertion into the cornea (27 eyes) was 15.1 ± 3.6%, and in cases of insertion into a TM (102 eyes), it was 5.2 ± 1.4%.

Conclusions

Insertion into the cornea was a risk factor for rapid ECD loss. The Ex-Press should be inserted into a TM for long-term protection of the corneal endothelial cells.

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Year 2020
Language English
Format PDF
DOI 10.1007/s10792-020-01286-8