Determinants of corneal endothelial cell loss after sulcus placement of Ahmed and Baerveldt drainage device surgery

Br J Ophthalmol. 2021 Jul;105(7):925-928. doi: 10.1136/bjophthalmol-2020-316379. Epub 2020 Jul 30.

Abstract

Aim: In patients who underwent multiple intraocular surgeries, we evaluated determinants of decreased corneal endothelial cell density (CECD) after sulcus placement following Ahmed and Baerveldt drainage device surgery.

Methods: We retrospectively reviewed consecutive patients with glaucoma who underwent sulcus placement with an Ahmed glaucoma valve or a Baerveldt glaucoma implant. We compared presurgical and postsurgical CECD and risk factors for decreased CECD.

Results: We examined 41 eyes of 41 patients. Postsurgical CECD measurements were assessed 2.0±1.0 times during a median follow-up period of 28 months. The mean intraocular pressure (IOP) decreased from 28.4±11.6 mmHg to 12.2±5.3 mmHg 24 months after the operation. At 24 months, CECD decreased 14.6±5.4% after considering the variability in the number and time points of CECD determinations. History of prior surgery and higher preoperative IOP were significantly associated with a trend for a time-dependent decrease in CECD.

Conclusions: Risk factors for decreased CECD after sulcus placement during Ahmed and Baerveldt drainage device surgery included the number of previous intraocular surgeries and higher presurgical IOP.

Keywords: Cornea; Glaucoma; Intraocular pressure; Treatment Surgery.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anterior Chamber / surgery*
  • Antihypertensive Agents / administration & dosage
  • Cell Count
  • Corneal Endothelial Cell Loss / diagnosis
  • Corneal Endothelial Cell Loss / epidemiology*
  • Endothelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Glaucoma Drainage Implants / adverse effects*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Tonometry, Ocular
  • Visual Acuity / physiology

Substances

  • Antihypertensive Agents