Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma

Introduction/Objective. Pseudoexfoliation syndrome is characterized by abnormal production and accumulation of fibrillar, white-gray, ?dandruff-like? material in almost all ocular structures. The aim of this study was to examine effect of selective laser trabeculoplast in pseudoexfoliation glaucoma patients. Methods. Thirty-two patients (47 eyes) were enrolled with medically uncontrolled pseudoexfoliation glaucoma. All patients could not reach target intraocular pressure with maximal tolerated medical therapy before treatment. Selective laser trabeculoplasty was performed with about 100 non-overlapping spots. Intraocular pressure was measured 1 hour, 7 days, 4 weeks, 3, 6, 12, 18 and 24 months after procedure. Results. The mean base intraocular pressure was 23.45 mmHg (SD = 3.07). Statistically significant reduction of mean intraocular pressure was observed at all follow-ups except 1 hour after treatment. Mean intraocular pressure after 24 months was 18.39mmHg (SD = 1.82). Success, defined as intraocular pressure reduction from base IOP of more than 20% after 24 months, was achieved in 27 eyes (57.45%). We did not find any influence of sex and age on selective laser trabeculoplasty effects in pseudoexfoliative glaucoma patients. Baseline intraocular pressure is proved to be reliable predictor of intraocular pressure lowering effect, as there were strong correlation between baseline intraocular pressure and percentage of reduction of intraocular pressure after 24 months (r = 0.71, p < 0.01). Conclusion. Selective laser trabeculoplasty is safe and effective method for reduction of intraocular pressure in pseudoexfoliation glaucoma patients and should be used more often in this challenging form of glaucoma. Baseline intraocular pressure seems to be reliable predictor of success.

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“…Our study confirmed that higher baseline IOP predicts higher hypotensive response and higher percentage of IOP reduction from baseline [28,29].…”

Section: Discussionsupporting

confidence: 86%

Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

et al. 2022

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“…[16] who also found a significantly higher CV in uveitis in patients with AS. Similarly, a recent study by Örnek and Örnek [18] reported that CD was significantly lower and CV was significantly higher in the RA group than in healthy subjects…”

Section: Discussionsupporting

confidence: 52%

Corneal Endothelial Changes with Different Rheumatic Diseases and Correlation with Disease Activity

El-Kady,

Rayan,

Amer

et al. 2024

International Journal of Medical Arts

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Article informationBackground: Rheumatoid arthritis [RA], systemic lupus erythematosus [SLE] and ankylosing spondylitis [AS] are chronic inflammatory diseases associated with progressive joint destruction, functional disability, reduced health-related quality of life, systemic complications, premature mortality, and a high economic burden. Aim of the work:The aim of this study is to evaluate the corneal endothelial changes that occur in ankylosing spondylitis, systemic lupus erythematosus, and rheumatoid arthritis. Patients and Methods: A cross-sectional study of 90 patients [thirty with RA, thirty with SLE, thirty with AS] and thirty healthy control patients. The study was conducted at the outpatient clinics of the rheumatology and rehabilitation department of Al-Azhar University hospitals. All patients were subjected to personal history, general and local examination, and laboratory tests to confirm diagnosis. They were then examined by specular microscope [Nidek CEM-530] to evaluate corneal cell morphology. Results: In RA patients, significant differences were found between RA and control groups regarding central corneal thickness and cell variation [CV]. No significant difference was found regarding cell density and hexagonality [HEX]. In SLE patients, significant differences were found between the SLE and control groups regarding central corneal thickness and cell density. No significant difference was found between the SLE and control groups regarding cell variation [CV] and hexagonality [HEX]. In AS patients, significant differences were found between them and control group regarding central corneal thickness, cell density, cell variation [CV], and hexagonality [HEX]. Conclusion: Rheumatoid arthritis [RA], systemic lupus erythematosus [SLE] and ankylosing spondylitis [AS] have a slight effect on cell density [CD], central corneal thickness [CCT], cell size, and cell shape permanently.

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“…13 Ornek et al have reported other causes that can lead to decreased corneal endothelial cell density like pseudoexfoliation (2510.6±220) when compared to control Group (2740.4±330) and some eyes after treatment with SLT (selective laser trabeculoplasty) 2488.2±348. 14 We have observed increased AVG in patients with uveitis than in healthy subjects. Guclu et al had similar observations regarding AVG in their study.…”

Section: Discussionmentioning

confidence: 66%

Comparison of Corneal Endothelium in Patients with Uveitis and Healthy Subjects Using Specular Microscopy

Ghazanfar

Zafar²,

Ahmed³

et al. 2022

PAFMJ

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Objective: To evaluate changes in corneal endothelium in patients with anterior uveitis by using specular microscopy and compare it with the corneal endothelium of healthy subjects. Study Design: Comparative cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jun 2018 to Jun 2019. Methodology: This study included 65 eyes of 65 patients with anterior uveitis and 65 eyes of healthy subjects. Corneal endothelium was assessed in all participants of both Groups by using Specular microscopy. Corneal endothelial markers like central corneal thickness (CCT), cell density (CD), cell minimum area, cell maximum area, the average of cell size, percent of hexagonality (HEX%), coefficient of variation (CV) were compared in both Groups. The Uveitis Group was further subdivided into active and inactive Uveitis Subgroups, and corneal endothelium markers were also compared in these Subgroups. Results: The mean endothelial cell density was 2626.0±413.0 cells/mm² in patients with uveitis, whereas cell density was 2766.0±327.0 cells/mm² in healthy subjects. The difference in endothelial cell density was statistically significant between the Groups (p=0.03). The difference between central corneal thickness, maximum cell area, average cell size and hexagonality values between Groups was also statistically significant, whereas there was no difference in terms of cell minimum area between these Groups. There was no statistically significant difference between inactive and active uveitis when corneal endothelial markers were compared between them (p>0.05). Conclusion: There was an effect of uveitis on central corneal thickness, endothelial cell density, cell size, and morphology compared to healthy subjects,......

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Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma

Abstract: Effect of a single session of SLT on corneal endothelium of PEG patients appears to be transient, and superior cornea was more affected than central and inferior cornea. All parameters returned to pre-SLT values at 1 month after treatment.

Cited by 17 publications

References 28 publications

Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

Corneal Endothelial Changes with Different Rheumatic Diseases and Correlation with Disease Activity

Comparison of Corneal Endothelium in Patients with Uveitis and Healthy Subjects Using Specular Microscopy

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