Corneal endothelium cell density changes in patients with primary glaucoma attending Bansara Eye Care Centre

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Objectives The objective of this clinical investigation was to determine the variations in corneal endothelial cell (CEC) density among individuals diagnosed with primary glaucoma at the Bansara Eye Care Centre. Material and Methods A cross-sectional, comparative hospital-based analysis was conducted involving 158 participants categorized into five cohorts: primary open-angle glaucoma (POAG, n = 30), primary angle-closure glaucoma (PACG, n = 30), normal-tension glaucoma (NTG, n = 11), ocular hypertension (OHTN, n = 8), and a healthy control group (n = 79). Data collection spanned from August 2022 to June 2023. Comprehensive ocular evaluations were performed, and corneal endothelial parameters were captured via non-contact specular microscopy. Quantitative data processing was performed using SPSS version 20.0. Data distribution was evaluated for normality using the Shapiro-Wilk test. An independent samples Student’s t-test was applied to determine differences in continuous variables between two distinct groups (e.g., comparing treated versus untreated patient subgroups). To assess disparities across three or more groups, such as the various glaucoma categories and the control group, a one-way analysis of variance (ANOVA) was utilized, followed by Tukey’s posthoc test for multiple pairwise comparisons. The Chi-square test was employed to evaluate differences in categorical variables, such as gender distribution across groups. Additionally, Pearson’s correlation coefficients were calculated to identify the relationship between intraocular pressure (IOP) levels, disease longevity, and corneal morphological traits. Results are presented as mean ± standard deviation (SD), with a p <0.05 defining statistical significance. Results Compared with controls, glaucoma patients exhibited significantly lower endothelial cell density (ECD) ( p <0.001), increased mean cell area ( p <0.001), and higher IOP ( p <0.001). Among the subgroups of glaucoma, PACG subjects demonstrated the most pronounced reduction in ECD and larger mean cell area compared to the other case groups. No statistically significant variance was observed across POAG to NTG ( p = 0.257) and OHTN ( p = 0.903), and NTG and OHTN ( p = 0.449). Patients on anti-glaucoma therapy demonstrated significantly lower ECD ( p = 0.039) and lower IOP ( p <0.001) than patients who were not on medication. Patients who have had glaucoma for >4 years have significantly lower corneal endothelium density ( p <0.001), larger mean cell area (MCA) ( p = 0.003), and lower IOP ( p < 0.001) compared to patients who had glaucoma for 2–4 years and <2 years. Conclusion This study confirms that glaucoma patients experience a substantial loss of CEC density compared to healthy subjects. Both chronic IOP elevation and the use of topical anti-glaucoma pharmacological agents are linked to this cellular decline. Future research should further investigate the impact of specific preservatives used in these medications and the cumulative effects of long-term treatment.