Evaluation Of Corneal Endothelial Cell Morphology By Confocal Microscopy In Post Trabeculectomy With Mitomycin-C Eyes

1. Nishant Nawani
2. Surinder Singh Pandav
3. Amit Gupta
4. Sushmita Kaushik

Advanced Eye Centre, PGIMER, Chandigarh, India.

Purpose: To study changes in corneal endothelial cell morphology by confocal microscopy post trabeculectomy with 0.04% mitomycin-c (MMC).

Methods: A prospective, non-randomized, interventional case series. Group I (n=15) comprised of patients who underwent trabeculectomy with 0.04% MMC applied for two minutes, Group II (n=15) those who underwent trabeculectomy alone. All patients underwent a detailed ophthalmological examination and confocal microscopy to study corneal endothelium preoperatively, and at 1 and 3 months post surgery. The central corneal endothelial count(CCEC), pleomorphism, polymegethism and the mean cell area(MCA) in both groups were compared.

Results: At baseline, both groups were similar. The CCEC in Group I reduced by 5.85% at 1 month (p=0.239) and by 5.46% at 3 months (p=0.374). In Group II CCEC reduced by 6.48% at 1 month (p=0.131) and 2.28% at 3 months (p=1). No significant change in pleomorphism and polymegethism occurred in either group. In Group I, MCA changed from 496.36 μm² preoperatively to 528.17 μm² at 1 month (p=0.099) and 525.78 μm² at 3 months (p=0.314). In Group II, MCA changed from 494.66 m2 preoperatively to 521.07 μm² at 1 month, (p=0.477) and 493.14 μm² at 3 months (p=1).

Conclusiuons: MMC 0.04% when applied for two minutes, shows no significant toxic effects on the corneal endothelium at 3 months following trabeculectomy.