Beth Ann Benetz

CWRU Dept of Ophthalmology & Visual Science, Cleveland, Ohio, USA

Purpose: To evaluate corneal endothelial cell changes following phacoemulsification with or without supraciliary micro-stent implantation in eyes with open-angle glaucoma (OAG) and cataract.

Methods: Central corneal endothelial images from patients who underwent micro-stent (M-S group) implantation plus phacoemulsification (n=282) or phacoemulsification alone (no M-S group) (n=67) were analyzed post-hoc up to 3 years after a 2-year randomized clinical trial (COMPASS) for cell loss (ECL) up to 60 months postoperatively, as well as change in coefficient of variation, and percentage of hexagonal cells.

Results: Mean ECL did not differ between the M-S and no M-S groups at month 24 (13% vs. 10%, respectively). At Months 48 and 60 ECL was greater in the M-S than the no M-S group. At Month 60, mean ECL was 20% in the M-S group and 10% in the no-MS group. No significant between-group changes from baseline in cellular morphology were observed. 9 adverse events were possibly related to ECL, including 3 eyes with transient focal corneal edema and 4 eyes that required micro-stent trimming due to protrusion.

Conclusion: In eyes with OAG, ECL following phacoemulsification is acute and stabilizes after 3 months, whereas ECL following phacoemulsification plus M-S implantation proceeds for at least 5 years. Clinical findings associated with ECL in these eyes were uncommon, suggesting that ECL is generally a subclinical phenomenon.