Corneal endothelial changes after selective laser trabeculoplasty.
BACKGROUND
Whitish spots are sometimes noted in the corneal endothelium after selective laser trabeculoplasty. To evaluate the corneal endothelium after selective laser trabeculoplasty, corneal specular microscopy was performed.


DESIGN
Prospective observational study in a private practice.


PARTICIPANTS
Fifteen consecutive patients with open-angle glaucoma undergoing selective laser trabeculoplasty in February 2012 had their corneal endothelium examined with specular microscopy before and after treatment.


METHODS
Selective laser trabeculoplasty was done with 50 ± 5 shots to 180 degrees of meshwork using 0.3-0.9 mJ of power to achieve the reaction of a hint of microbubbles in 80% of laser shots.


MAIN OUTCOME MEASURES
Corneal specular microscopy photographs (0.25 × 0.54 mm) were taken prior to, immediately after and 1 month after selective laser trabeculoplasty. These photographs were assessed and graded.


RESULTS
Of the 15 patients, three showed numerous, four showed few and eight showed no increase of dark spots after selective laser trabeculoplasty. All the dark spots resolved by 1 month.


CONCLUSION
The effect of selective laser trabeculoplasty on the corneal endothelium may be transient, and long-term effects are probably negligible in normal corneas. However, in compromised corneas and corneas with pigment deposits on endothelium, there may be a risk of corneal endothelial compromise, especially after repeated selective laser trabeculoplasty. Larger and longer term studies with histopathological evaluation would be useful to evaluate the effect of selective laser trabeculoplasty on normal and subnormal corneal endothelium. Until further studies are done, it would be wise to minimize the number and energy of laser shots.
['Ong|Keith|K|', 'Ong|Lillian|L|', 'Ong|Leonard|L|']
D002452:Cell Count D003316:Corneal Diseases D004728:Endothelium, Corneal D005902:Glaucoma, Open-Angle D006801:Humans D053685:Laser Therapy D011446:Prospective Studies D014130:Trabeculectomy
corneal endothelium glaucoma laser surgery