Effect of Mitomycin-C augmented trabeculectomy on corneal endothelial cells

Purpose: to evaluate the effect of mitomycin-c (mmc) on corneal endothelial cell density (ecd) and morphology after trabeculectomy. methods: in this prospective comparative case series,31 eyes with glaucoma underwent trabeculectomy with (group i),or without (group ii) mmc. specular microscopy was performed pre-,and postoperatively at months 1 and 3. outcome measures included central corneal endothelial cell count and coefficient of variation (cv) of cell size. results: overall,mean preoperative ecd was 2,135.8 ± 397.6 cells/mm2; corresponding values at postoperative months 1 and 3 were 2,019.6 ± 447.2 cells/mm2,and 1,991.4 ± 425.5 cells/mm2,respectively (p > 0.05). cell loss from month 1 to 3 was 1.3 % (p > 0.05). subgroup analysis showed significant differences in endothelial cell loss at month 1 (p = 0.048) and month 3 (p = 0.014) between the mmc and control groups with no significant difference between the two groups in terms of cell loss from months 1 to 3,postoperatively (p = 0.968). overall,mean pre-and postoperative cvs at months 1 and 3 were 27.38 ± 4.55,27.96 ± 4.26,and 28.35 ± 4.47,respectively,with no significant difference between the two groups (p > 0.05). there was no correlation between preoperative central endothelial cell density (cecd) and mmc related cell loss. conclusion: mmc application in trabeculectomy seems to cause a small but significant corneal endothelial loss. most of the damage occurs intraoperatively,or in the early postoperative period,however progressive endothelial cell loss is not a major concern. © 2015 journal of ophthalmic and vision research | published by wolters kluwer - medknow.