Case-Control Study of Corneal Endothelial Cell Density in Primary Open-Angle Glaucoma Patients Versus Normal Population Using Specular Microscopy in Rawalpindi, Pakistan

Abstract

Objective: To assess Endothelial cell counts in the corneas of patients with primary open-angle glaucoma
(POAG) as compared to age-matched healthy individuals using Corneal Specular Microscopy.
Study Design: Case-control study.
Place and Duration of Study: This study was conducted at the Armed Forces Institute of Ophthalmology (AFIO),
Rawalpindi, Pakistan from December 2023 to May 2024.
Methods: A total of 50 individuals were recruited, including 25 phakic Primary Open Angle Glaucoma patients
on antiglaucoma medications for at least five consecutive years. They were compared with 25 healthy phakic
individuals as controls. All the individuals were aged 50-60 years. Intraocular pressure (IOP) was recorded using
Goldmann Applanation Tonometry (GAT). Endothelial cell density was measured using Indirect Specular
Microscopy SP-3000P® in both groups after thorough ophthalmological examination. SPSS 25 was used for
statistical analysis. Age was stratified into 3-year intervals from 50 to 60 years. Paired sample t-test was
employed to assess the mean difference, and a P-value <0.05 was considered statistically significant.
Results: Among included participants ( N=50), 26 (52%) were males and 24 (48%) were females. Participants
had a mean age of 55.08 ± 2.48 years. The mean endothelial cell count in Primary Open Angle Glaucoma
patients was 2067±155 cells/mm² compared to controls 2715±315 cells/mm² (P=0.0001). There was no
statistically significant difference in endothelial cell counts (in cells/mm²) between males and females or across
stratified age groups. (P > 0.05)
Conclusion: Primary Open Angle Glaucoma patients exhibit significantly reduced endothelial cell density
compared to healthy individuals. Chronic intraocular pressure elevation and long-term exposure to antiglaucoma medications may contribute to endothelial loss of cells.

How to cite this: Sajjad S, Rauf A, Haider MK, Zahra SM, Naseer MS, Zahra F. Case-Control Study of Corneal Endothelial Cell Density in Primary Open-Angle Glaucoma Patients Versus Normal Population Using Specular Microscopy in Rawalpindi, Pakistan. Life and Science. 2025; 6(3): 381-386. doi: http://doi.org/10.37185/LnS.1.1.887