Corneal endothelium status as a criterion for assessing the safety of the technique in the combined treatment of patients with glaucoma and cataract

PURPOSE. To evaluate corneal endothelial status in patients with primary open-angle glaucoma and complicated cataract undergoing combined micropulse transscleral cyclophotocoagulation (MP-CPC) and cataract phacoemulsification with intraocular lens implantation (PE+IOL).

METHODS. This prospective study included 62 patients with stage I–II primary open-angle glaucoma and complicated cataract who underwent surgical treatment. The study group comprised 33 patients who received combined intervention (MP-CPC+PE+IOL), while the control group included 32 patients who only underwent PE+IOL. Corneal endothelial status was assessed using the Tomey EM-3000 specular microscope preoperatively and at 1, 3, 6, and 12 months after surgery.

RESULTS. In both groups, a moderate decrease in endothelial cell density was observed during the early postoperative period, with the most pronounced reduction at 1 month (up to 11.8%), followed by stabilization. At 12 months, the mean endothelial cell loss was less than 10%, with no statistically significant differences between the groups (p>0.05). Best-corrected visual acuity improved significantly compared with baseline. No progression of glaucomatous damage was detected by perimetry and optical coherence tomography. The incidence of postoperative intraocular pressure elevation was comparable between the groups.

CONCLUSION. The combined use of MP-CPC and PE+IOL demonstrates a satisfactory safety profile and does not exert a significant negative effect on corneal endothelial status compared with isolated phacoemulsification. The obtained results support the feasibility of the combined approach in patients with concomitant ophthalmic pathology.

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