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

Tony Realini, Preeya K. Gupta, Nathan M. Radcliffe, Sumit Garg, William F. Wiley, Elizabeth Yeu, John P. Berdahl, Malik Y. Kahook

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


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.

Original languageEnglish
Pages (from-to)209-218
Number of pages10
JournalJournal of Glaucoma
Issue number3
StatePublished - Mar 2021
Externally publishedYes


  • corneal endothelial cells
  • endothelial cell loss
  • glaucoma
  • glaucoma surgery
  • glaucoma therapy
  • intraocular pressure
  • lasers


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