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Post operative endothelial cell loss: comparison between phaco-express implant, phaco-safe trabeculectomy and phaco-trabecular stent

Poster Details

First Author: R.Altafini ITALY

Co Author(s):    A. Fea   S. Morselli   G. Consolandi   P. Cannizzo   G. Pignata  

Abstract Details


To evaluate corneal endothelial cell loss after phaco with ExPress implant compared to phaco safe trabeculectomy and to phaco with the implant of trabecular stent (Hydrus, Ivantis)


Ophthalmology Department “S.Bassiano Hospital”, Bassano del Grappa, Vicenza – Italy, Department of Clinical Pathophysiology,University of Turin, Italy


Sixty eyes of 60 patients affected by cataract and open angle glaucoma were randomized to underwent a Micro incision cataract surgery (MICS) phaco with Express P50 implant under scleral flap (group 1 ,20 eyes) compare together with MICS safe-phacotrabeculectomy (group 2, 20 eyes) and compared also with 20 eyes who underwent a MICS with the implant of a new trabecular stent (Hydrus) (group 3). Glaucoma and cataract surgery were performed, in all eyes, with 2 separate incisions. There were no statistically significant differences in age, sex, anterior chamber depth and axial length. Non contact corneal specular microscopy was performed before surgery and at the 3th and 6th months after surgery. Endothelial cell density (CCD), coefficient of variation in cell size (CV) and percentage of hexagram cells (HEX) between the three groups were considered before and after surgery. One-way analysis of variance (ANOVA) was used to analyze endothelial cell loss differences between 3 groups.


The mean preoperative endothelial cell density in group 1 (ECD) was 2144 ±267 cells/mm(2), 2203 ±269 cells/mm(2) in group 2 and 2461±315 cells/mm(2) in group 3 . The mean postoperatively endothelial cell loss at 6th month was 12,6 ±9.4% in group 1 , 12.3% ±8.9% in group 2 and 11.6ḟ10.6% in group 3. The differences were not statistically significant between the three groups (P >.05). The percentage of hexagonal cells and coefficient of variation in cell size were not different between the three groups preoperatively or postoperatively.


Endothelial cell loss following the implant of new devices for glaucoma surgery combined with phacoemulsification is safe and effective surgical techniques.

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