Discussion
trauma, cataract, endothelial cell loss, non-filtering glaucoma
CATARACT, LENS, COMPLICATION, IOL
Corneal endothelial cell loss is a well-described complication after anterior segment surgery and has been reported after filtering and non-filtering glaucoma surgeries [In both the solo surgery group as well as in the combined surgery group, the observed loss of endothelial cell count was − 1% (95% CI: − 7 to 4%) at 5 years compared to baseline. In general, the observed reduction of endothelial cell count was less or equal to − 4% after 1–5 years of follow-up in the entire study population as well as in the solo and the combined surgery subgroups.Pairwise comparisons of baseline and postoperative visits revealed a decrease in central endothelial cell counts at 2 and 4 years postoperative overall (− 1%, − 3%) as well as in the combined surgery group (− 3%, − 4%). No statistically significant change was found for 1, 3, and 5 years postoperatively. Our data further suggest a slow, continual decrease of endothelial cell counts over time after combined surgery/cataract surgeries as opposed to a single decrease in endothelial cell count due to surgical trauma without a further decrease of endothelial cell counts over time. We want to point out that solo cataract surgeries can lead to a decrease in central endothelial cell counts (up to − 21% after 11 years) [The observed differences between solo and combined surgery groups in the study could be explained by the surgical step of removal of the lens and implanting an IOL, which could put more stress on the endothelial cells in the combined surgery group.The solo surgery group showed no statistically significant decrease in central endothelial cell counts in all postoperative visits (1–5 years).