EFFECTS OF GLAUCOMA SURGERY ON CORNEAL ENDOTHELIAL CELLS (GICES)
Research type
Research Study
Full title
EFFECTS OF GLAUCOMA SURGERY ON CORNEAL ENDOTHELIAL CELLS (GICES)
IRAS ID
120353
Contact name
Velota Sung
Contact email
Sponsor organisation
Sandwell & West Birmingham NHS Trust R&D Department
Research summary
Glaucoma is the second leading cause of blindness worldwide. Its characteristics include optic neuropathy, visual field loss and usually but not always associated with raised intraocular pressure. Although glaucoma and its spectrum of diseases are categorised in many ways, they shared a common feature. This feature is the disruption of aqueous humor production and outflow equilibrium.
Various surgical options are available when first-line medical treatments have failed in controlling intraocular pressure and glaucoma progression. Professor Anthony Molteno first introduced tube-shunt implant surgery in 1969 (Danesh-Meyer et al., 2005). This has become useful in treating glaucoma unresponsive to maximal medical therapy, where previous unsuccessful guarded filtering surgery (trabeculectomy) is likely to fail (Danesh-Meyer et al., 2005).
However, tube-shunt implants are not without its’ complications, for example chronic hypotony, retinal detachment, malignant glaucoma, endophthalmitis. Chang et al. also described changes in cornea endothelial cell density and morphology within the first year of tube implantation. In addition, Hau’s team or researchers recently studied the risk factor for endothelial cell loss after glaucoma tube-shunt surgery in a small cohort of patients (Hau et al., 2011).
When the corneal endothelium function impairment is at a critical level known as decompensation, the cornea will become opaque resulting in reduction of vision. These patients will need corneal transplant surgery (penetrating keratoplasty or endothelial keratoplasty) to improve their vision. Therefore, this study aims to further investigate the long-term effects of glaucoma tube-shunt implants and trabeculectomy on the corneal endothelial cell in normal cornea of a cohort of adult and paediatric glaucoma patients.
REC name
North West - Preston Research Ethics Committee
REC reference
14/NW/0327
Date of REC Opinion
13 May 2014
REC opinion
Favourable Opinion