Perda de células endoteliais da córnea associada às cirurgias minimamente invasivas de glaucoma: uma revisão de literatura

Abstract

Objective: To review the literature regarding corneal endothelial cell loss (CEL) associated with minimally invasive glaucoma surgeries (MIGS). Method: Literature review using the PUBMED database focusing on the different modalities of MIGS. Results: Trabecular MIGS in general did not show a significant increase in CEL in the combined surgery compared to PHACO (phacoemulsification) alone. The Hydrus implant associated with PHACO showed greater CEL than PHACO alone, with more patients presenting endothelial loss greater than 30%, but without a progressive increase in rates over time. Similarly, the implantation of the first-generation iStent suggests additional CEL when compared to trabecular MIGS techniques that do not involve implantation. Regarding subconjunctival MIGS, XEN associated with PHACO showed CEL comparable to that of PHACO alone, but showed additional CEL in evaluations at the 60-month follow-up, which may be associated with the presence of the device. PRESERFLO alone showed low ECL in some studies and no ECL in others. Regarding suprachoroidal MIGS, Cypass showed continuous ECL at 60 months of follow-up, with 27.2% of patients presenting ECL greater than 30%. MINIJECT showed low ECL at 60 months of follow-up, with no patients presenting a reduction greater than 30% during the period. Conclusion: In general, the MIGS included in this review showed good safety both as an isolated procedure and in combined surgery. Among trabecular MIGS, techniques involving implants may be associated with higher ECL.