Effect Of Acute Angle-Closure Glaucoma On The Corneal Endothelium

ObjectiveTo study the quantitative morphometric changes of the corneal endothelial cellsin acute angle-closure glaucoma (AACG) and analyze the correlated factors of these changes. To investigate the effect of trabeculectomy on corneal endothelial cells and explore the related factors on the quantitative morphometric changes of the corneal endothelial cells after the surgery.MethodsA total of 27 patients with acute angle-closure glaucoma were selected. All of thepatients were examined for cell density (CD), percentage of hexagonal cells, average cellular area of corneal endothelium cells by non-contact specular microscope and computer-aid image analysis system. Some indexes such as anterior chamber depth(ACD). angle of anterior chamber, pupil diameter(PD), central corneal thickness(CCT) were measured also. Then they were grouped according to pathogenetic condition: the control group (eyes in preclinical stage, 27) and the acute attack group (eyes in acute attack stage, 27). The acute attack group was divided into two groups by the intraocular pressure: A₁ group (<60mmHg) and B₁ group (≥ 60mmHg), and grouped by the course of the disease: A₂ group (<3days) and B₂ group (≥3days). The quantitative morphometric difference of the corneal endothelial cells between the acute attack group and the control group, A₁ group and B₁ group, A₂ group and B₂ group was analyzed. Then the relationship between CD and those indexes such as ACD, the angle of anterior chamber, PD and CCT was investigated in both attack group and control group. Then the same indexes such as CD, ACD, the angle of anterior chamber, PD, CCT and so on were measured after trabeculectomy and named this group as the postoperative group. The quantitative morphometric difference of the corneal endothelial cells between the acute attack group and the postoperative group was analyzed, and the correlation of the measured indexes and the decrease of the CD was investigated.ResultsAs compared with the control group, the acute attack group was significantly decreased in cell density and percentage of hexagonal cells ( P <0.01) but increased in average cellular area (P <0.01). There was significant difference between A₁ group and B₁ group, A₂ group and B₂ group in cell density and average cellular area of the corneal endothelium (P <0.01). The depth of anterior chamber is shallower, the angle of anterior chamber is narrower and the PD is bigger in the acute attack group when it was compared with the control group, but there was no significant difference in CCT. CD of the acute attack group was positively related to ACD and the angle of anterior chamber (P <0.05), but no significant relation was found in CD with PD and CCT (P>0.05). No significant relation was found in CD with ACD, angle of anterior chamber, PD and CCT (P>0.05). There was no significant difference between the postoperative group and the acute attack group in the indexes of corneal endothelial cells (P>0.05). It was found that the decrease of CD after the surgery was significantly related to ACD, angle of anterior chamber (P <0.05), but there was no significant relation in CD with PD and CCT (P>0.05). ConclusionThe density and morphous of the corneal endothelial cells was greatly changed inpatients with AACG. The CD of the corneal endothelial cells was significantly related to the intraocular pressure with the course of the disease. And the CD of those eyes in acute attack stage was positively related to ACD and the angle of anterior chamber but no significant relation was found in CD with CCT and PD. The regular operation does not significantly affect the function of the corneal endothelial cells. The decrease of CD after operation was significantly related to ACD and the angle of anterior chamber, but no significant relation was found in the decrease of the CD with PD and CCT.