Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Mar 1;30(3):209-218.
doi: 10.1097/IJG.0000000000001722.

The Effects of Glaucoma and Glaucoma Therapies on Corneal Endothelial Cell Density

Tony Realini  1 , Preeya K Gupta  2 , Nathan M Radcliffe  3 , Sumit Garg  4 , William F Wiley  5 , Elizabeth Yeu  6 , John P Berdahl  7 , Malik Y Kahook  8
Affiliations
Review

The Effects of Glaucoma and Glaucoma Therapies on Corneal Endothelial Cell Density

Tony Realini et al. J Glaucoma. .

Abstract

A healthy corneal endothelium is required for corneal clarity. Both the glaucoma disease state and its various forms of treatment can have adverse effects on the corneal endothelium. Both the presence of glaucoma and the magnitude of intraocular pressure elevation are related to endothelial cell loss (ECL). Topical medical therapy, laser procedures, and both traditional surgeries-trabeculectomy and tube-shunts-and newer minimally invasive glaucoma surgeries have variable effects on ECL. This review will summarize the reported effects of glaucoma and its treatment on ECL. Concerns for corneal endothelial cell health should be part of the decision-making process when planning glaucoma therapy for lowering intraocular pressure, with added caution in case of planned device implantation in eyes with preexisting ECL and low endothelial cell density at high risk for corneal endothelial decompensation.

PubMed Disclaimer

Conflict of interest statement

Disclosure: T.R. serves as a consultant in Aerie, Asclepix, Ivantis, New World Medical, Nicox, Notal Vision, Ocular Therapeutix, Sight Sciences. M.Y.K. has ownership (all current) at Spyglass Ophthalmics, Ivantis, Equinox, Aurea Medical, ShapeTech; has royalties (all current) in Alcon, Johnson and Johnson Vision, New World Medical, ShapeTech, Spyglass Ophthalmics; serves as a consultant (all current) in Alcon and New World Medical. E.Y.: Alcon: C, R. Allergan: C. Avedro: C. Bausch & Lomb/Valeant: C. BioTissue: C, R. Beaver Visitec: C. BlephEx: C, O. Bruder: C. CorneaGen: C, O. Dompe: C. Equinox: O. Expert Opinion: C. EyePoint Pharmaceuticals: C. Glaukos: S. Guidepoint: C. J & J Vision: C. Kala Pharmaceuticals: C. LENSAR: C. Mati: O. Melt: C, O. Modernizing Medicine: O. Merck: C. Mynosys: C. Novartis: C. Ocular Science: C, R, O. Ocular Therapeutix: C. Ocusoft: C. Omeros: C. Oyster Point Pharmaceuticals: C, O. Science Based Health: C. Shire: C. Sight Sciences: C. Sun: C. Surface: C. Thea: C. Tarsus: C, O. TopCon: C, R. Tear Lab Corporation: C, R. Visus Therapeutics: C. Zeiss: C. P.K.G.:. Consultant to:. Alcon. Allergan. HanAll Biopharma. J&J Vision. Kala. New World Medical. Novartis. Ocular Therapeutix. Oyster Point. ReGenTree. Sight Sciences. Sun Pharmaceuticals. Tear Lab. Tissue Tech Inc. Zeiss. S.G.: Aerie—C (past). Alcon—C (past). Allergan—C (current). CorneaGen—C (current). Dompe—C (current). Eyepoint—C (past). Glaukos—C (current). Ivantis—C (past). Johnson and Johnson Vision—C (current). Kala—C (past). LensGen—C, O (current). New World Medical—C (past). Novartis—C, (current). OcuTrx—C, O (past). SightSciences—C (current). Spyglass—C, O (current). Tarsus—C, O (current). Verana Health—C (past). Visioncare—C (current). Zeiss—C (current). W.F.W.:. Ivantis: consultant, stock options. Glaucos: consultant. New World Medical: consultant. Alcon: consultant. Allergan: consultant. N.M.R.: CATS LLC—Consultant. Allergan—Consultant, speaker. Alcon—Consultant, speaker. Novartis—Consultant, speaker. Eyenovia—Consultant. Lumenis—Consultant. Equinox—Consultant, investor. Iridex—Consultant. Aerie—Consultant, speaker. Bausch & Lomb/Valeant—Consultant, speaker. BVI—Consultant, speaker. Eyepoint—Consultant. Ivantis—Consultant, speaker. Glaukos—Consultant, speaker. Alimera—Consultant, speaker. New World Medical—Consultant, speaker. SpyGlass—Consultant. Sight Sciences—Consultant, speaker. Thea—Consultant. Reichert—Consultant. Shire—Consultant. Carl Zeiss Meditec—Consultant. Omeros—Consultant. J.P.B.: Alcon L, C. Allergan L, C. Avedro C. Aurea Medical C. Bausch And Lomb C. CorneaGen C, O. Dakota Lions Eye Bank C. Equinox C, O. Expert Opinion C, O. Glaukos C, L. Gore C. Imprimis/Harrow Health C, P. JNJ C. Kala C. Kedalion C. MELT Pharmaceuticals C. MicroOptix C. New World Medical C. Ocular Surgical Data C, O. Ocular Theraputix C. Omega Ophthalmic C, O. Orasis C. Oyster Point. RxSight C. Surface Inc C, O. Tarsus C. Tear Clear C. Vittamed C. Vance Thompson Vision C, O. Verana Health (Digisight) O. Visionary Ventures C. Zeiss C, O. The remaining authors declare no conflict of interest.

References

    1. Bourne WM. Biology of the corneal endothelium in health and disease. Eye. 2003;17:912–918.
    1. Edelhauser HF, Geroski DH, Stern ME. Glucose metabolism in the cornea and lens in elasmobranchs, teleosts and mammals: response to thiol-oxidation. Fed Proc. 1980;39:3213–3221.
    1. Maurice DMDavson H. The cornea and sclera. The Eye, 3rd ed. Orlando, FL: Academic Press; 1984:85.
    1. Murphy C, Alvarado J, Juster R, et al. Prenatal and postnatal cellularity of the human corneal endothelium. A quantitative histologic study. Invest Ophthalmol Vis Sci. 1984;25:312–322.
    1. Edelhauser HF. The balance between corneal transparency and edema: the Proctor Lecture. Invest Ophthalmol Vis Sci. 2006;47:1754–1767.