Impact of preoperative intraocular pressure on corneal endothelial cell loss after phacoemulsification in acute primary angle-closure glaucoma with cataracts

作者：Jiaqi Shen, Xin Liu, Mingyue Lin, Yuting Shao, Guozhen Niu, Shen Qu, Yunli Niu, Qi Zhou, Li Zhang, Yanlong Bi · 发表于：Frontiers in Medicine · 年份：2025 · DOI：10.3389/fmed.2025.1533950 · 被引用次数：2 · 研究领域：Glaucoma and retinal disorders、Corneal surgery and disorders、Intraocular Surgery and Lenses

Purpose This study aimed to assess corneal endothelial cell loss (ECL) following phacoemulsification and intraocular lens implantation (Phaco+IOL) in eyes with acute primary angle-closure glaucoma (APACG) and cataracts under different preoperative intraocular pressure (IOP) levels. Methods This non-randomized controlled trial included 75 eyes from 75 patients with APACG and cataracts who underwent Phaco+IOL. All patients received pharmacotherapy and anterior chamber paracentesis before surgery and were grouped according to their preoperative IOP: the high-IOP group (IOP ≥ 25 mmHg) and the IOP-controlled group (IOP < 25 mmHg). IOP, visual outcome, endothelial cell density (ECD), hexagonality (HEX), coefficient of variation (CV), and central corneal thickness (CCT) were evaluated up to 3 months postoperatively. Baseline ECD, HEX, and CV parameters were measured in the contralateral eyes of all patients as a reference and compared with the postoperative results. Results The average IOP decreased from 43.2 ± 4.8 mmHg to 16.5 ± 5.8 mmHg ( p < 0.001) in the high-IOP group and from 18.3 ± 4.3 mmHg to 14.3 ± 3.2 mmHg ( p < 0.001) in the IOP-controlled group on the first postoperative day. The changes in IOP were more significant in the high-IOP group ( p < 0.001). The ECD at 3 months was 1705.2 ± 503.8 cells/mm 2 in the high-IOP group and 2091.8 ± 330.1 cells/mm 2 in the IOP-controlled group ( p < 0.001). The ECL rates at 3 months were 35.0% (high-I...