The glaucoma - cornea interplay: A review

Abstract

Glaucoma, the leading cause of irreversible blindness worldwide, and the cornea, has a quite complex, bidirectional relationship. The diagnosis and management of glaucoma is partly affected by corneal properties and changes such as corneal thickness, biomechanics and prior surgery. Similarly, glaucoma, the disease itself, at its lines of management, whether medical treatments, laser modalities, or incisional surgeries can alter the cornea, in different ways. Following the withdrawal of The CyPass Micro-Stent, a promising minimally invasive glaucoma implant, after concerns about its effect on the corneal endothelium, the influence of glaucoma surgeries, particularly hardware involving surgeries, on the corneal endothelium has become an area of growing interest. Corneal transplant surgeries that may be needed following glaucoma surgery related endothelial decompensation would represent an extra burden in the setting of developing countries with limited resources. Furthermore, these surgeries are more likely to fail, when glaucoma co-exists.