[Clinical observation of the 6-month safety of the corneal endothelium after trabeculotome tunnelling trabeculoplasty surgery].

Objective

To evaluate the safety of trabeculotome tunnelling trabeculoplasty (3T) in treating primary open-angle glaucoma (POAG) by observing the changes in corneal endothelial cell quantity and morphology after surgery.

Methods

This was a retrospective case series study. Patients diagnosed with POAG who underwent successful 3T surgery were recruited from the Department of Ophthalmology, Chengdu First People's Hospital between April 2023 and September 2025. Parameters such as the number of cells, corneal endothelial cell density, average size, hexagonal cell ratio of endothelial cells, and central corneal thickness were recorded preoperatively and at 6 months postoperatively. Data were analyzed using the t-test.

Results

The cohort comprised 48 patients, involving 52 eyes (27 left eyes, 25 right eyes), of whom 36 (75%) were male and 12 (25%) were female. The mean age of the patients was (51.37±12.90) years, ranging from 18 to 72 years. The preoperative number of cells was (196±40) cells, which decreased to (170±56) cells at 6 months postoperatively (P<0.05). The preoperative endothelial cell density was (2 686±416) cells/mm², compared to (2 302±563) cells/mm² at 6 months postoperatively (P<0.05). The average size increased from (381±76) μm² preoperatively to (470±161) μm² at 6 months postoperatively (P<0.05). The hexagonal cell ratio was (52±9)% preoperatively and (50±8)% at 6 months postoperatively, with no significant difference (P>0.05). The central corneal thickness was (517±49) μm preoperatively and (514±39) μm at 6 months postoperatively, with no significant difference (P>0.05).

Conclusions

Although the 3T surgery for POAG results in a slight reduction in corneal endothelial cell count, as well as changes in corneal endothelial cell morphology and size, it does not induce corneal endothelial decompensation during the 6-month follow-up period and shows favorable short-term safety.