الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Antimetabolites, are commonly used adjunctively to
trabeculectomy to prevent scarring of the filtering bleb, and improve
the success rate of the surgery but antimetabolite has a cytotoxic effect
that is independent of cell cycle. This study was to evaluate the effect
of antimetabolite on corneal endothelial density and morphology in
glaucoma patients who underwent trabeculectomy.
Topcon sp-2000 a non-contact specular microscopy was used
for analysis of the corneal endothelial cell layer by measurement of
mean cell density (MCD) and coefficient of variation (CV) in the cell.
These parameters provide an index of the functional status of corneal
endothelial layer. This study was performed on 30 eyes and
parameters were compared before, 1 week, 3 and 6 months after
surgery.
CECD was significantly lower after 1 week of surgery
(P=0.024) as the mean CECD decreased from 2739.47±591.41cells/
mm2 to 2429.17±503.89 cells/mm2 .This decrease continued from
1week to 6 months but was not significant as the mean CECD at 3
months was 2424.80±502.64 cells/ mm2 and 2418.30±501.23
cells/mm2 at 6 months (P=0.936).
The mean variation of cell size [coefficient of variation (CV)]
showed tendency to increase as it was 50.07±15.85% before surgery,
increasing to 52.30±16.10% after 1 week, 53.47±15.95% after 3
months and 53.93±15.89% after 6 months. This postoperative
variation (after 1week, 3months&6months) was not significant
(P=0.589-0.411-0.350) and also from 1week to 6 months (P=0.692)
This showed that although antimetabolite application in
trabeculectomy caused significant but also not clinically remarkable
loss of endothelial cells that occurred only intraoperatively or at early
post-operative period, prolonged toxic effect of antimetabolite and
progressive cell loss was not a major concern. During the follow up
period active endothelial adaptations were taking place.