Effect of a Previous Acute Angle Closure Attack on the Corneal Endothelial Cell Density in Chronic Angle Closure Glaucoma Patients

Abstract

Purpose 

To document the effect of a previous acute angle closure attack on the corneal endothelial cell density in chronic angle closure glaucoma (CACG) patients.

Methods 

Consecutive cases of CACG with patent peripheral iridotomy had their central corneal endothelial cell density measured by specular microscopy. The corneal endothelial cell density of those CACG eyes with a previous documented acute angle closure attack were compared with those eyes without such a history, to determine the effect of a previous acute angle closure attack on corneal endothelial cell density.

Results 

From July 2003 to July 2005, a total of 52 CACG eyes of 52 patients fulfilling the study criteria were recruited. Thirteen eyes (25%) had a previous documented acute angle closure attack, whereas 39 eyes (75%) did not. The mean central corneal endothelial cell density ±1 standard deviation was 2271.7±312.9 (range, 1556 to 2661) cells/mm² in those CACG eyes with previous acute angle closure, and 2570.0±429.9 (range, 1669 to 3861) cells/mm² in those CACG eyes without previous acute angle closure (P<0.05, Student t test). A previous acute angle closure attack in a CACG eye correlates with a 11.6% reduction in corneal endothelial cell density, compared with a CACG eye without such a history. There were no statistically significant differences between the 2 groups in age, LogMAR visual acuity, intraocular pressure, number of glaucoma eye drops, vertical cup-to-disk ratio, mean deviation or pattern standard deviation in Humphrey automated perimetry (P>0.05).

Conclusions 

A previous acute angle closure attack correlates with a significantly reduced corneal endothelial cell density in CACG patients.