{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:21:29Z","timestamp":1772018489712,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,8,27]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aim to systematically assess and compare corneal endothelial cell density (ECD) loss in patients with glaucoma following glaucoma surgery and cataract surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Corneal ECD loss may occur due to intraoperative surgical trauma in glaucoma surgery or postoperatively with chronic endothelial cell trauma or irritation. Corneal oedema and decompensation after aqueous shunt glaucoma surgery has been reported but the long-term ECD loss is still unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Inclusion criteria<\/jats:title>\n                  <jats:p>Trabeculectomy, glaucoma filtration surgery or microinvasive glaucoma surgery in adults with ocular hypertension, primary and secondary open angle glaucoma, normal tension glaucoma and angle-closure glaucoma. Participants with pre-existing corneal disease will be excluded. Glaucoma laser treatments and peripheral iridotomy will be excluded. The outcomes include preoperative and postoperative corneal ECD, percentage change of corneal ECD and adverse events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We will conduct an electronic database search for randomised controlled trials, prospective non-randomised studies, observational studies in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and The International Prospective Register of Systematic Reviews (PROSPERO). Eligibility criteria will include quantitative articles published after and including the year 2000, written in English and containing data on ECD loss. Two independent reviewers will screen titles and abstracts and extract data from full texts, reporting outcomes according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction of key characteristics will be completed using customised forms. Methodological quality will be assessed using the Joanna Briggs Institute critical appraisal forms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethics approval is not required for this review, as it will only include published data. Findings will be published in a peer-reviewed journal and disseminated across ophthalmic networks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>PROSPERO CRD42020192303.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050992","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T11:38:05Z","timestamp":1631533085000},"page":"e050992","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Corneal endothelial cell density loss following glaucoma surgery alone or in combination with cataract surgery: a systematic review protocol"],"prefix":"10.1136","volume":"11","author":[{"given":"Clarissa E H","family":"Fang","sequence":"first","affiliation":[{"name":"University College London Institute of Ophthalmology, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng Tee","family":"Khaw","sequence":"additional","affiliation":[{"name":"University College London Institute of Ophthalmology, London, UK"},{"name":"NIHR Moorfields Biomedical Research Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmi G","family":"Mathew","sequence":"additional","affiliation":[{"name":"University College London Institute of Ophthalmology, London, UK"},{"name":"Moorfields Eye Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6972-5355","authenticated-orcid":false,"given":"Christin","family":"Henein","sequence":"additional","affiliation":[{"name":"University College London Institute of Ophthalmology, London, UK"},{"name":"NIHR Moorfields Biomedical Research Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,13]]},"reference":[{"key":"2025101810132505000_11.9.e050992.1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.05-1139"},{"key":"2025101810132505000_11.9.e050992.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2017.11.002"},{"key":"2025101810132505000_11.9.e050992.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-9071.2003.00710.x"},{"key":"2025101810132505000_11.9.e050992.4","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000170"},{"key":"2025101810132505000_11.9.e050992.5","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1001\/jamaophthalmol.2014.3923","article-title":"Factors associated with corneal graft survival in the cornea donor study","volume":"133","author":"Sugar","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2025101810132505000_11.9.e050992.6","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/00003226-199705000-00010","article-title":"Corneal endothelial cell density in glaucoma","volume":"16","author":"Gagnon","year":"1997","journal-title":"Cornea"},{"key":"2025101810132505000_11.9.e050992.7","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.12998\/wjcc.v7.i15.1978","article-title":"Changes in corneal endothelial cell density in patients with primary open-angle glaucoma","volume":"7","author":"Yu","year":"2019","journal-title":"World J Clin Cases"},{"key":"2025101810132505000_11.9.e050992.8","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e328325a54b"},{"key":"2025101810132505000_11.9.e050992.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.06.035"},{"key":"2025101810132505000_11.9.e050992.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.08.043"},{"key":"2025101810132505000_11.9.e050992.11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1177\/112067210201200106","article-title":"Long-Term evaluation of endothelial cell loss after phacoemulsification","volume":"12","author":"Lesiewska-Junk","year":"2002","journal-title":"Eur J Ophthalmol"},{"key":"2025101810132505000_11.9.e050992.12","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/S0161-6420(94)31224-3","article-title":"Continued endothelial cell loss ten years after lens implantation","volume":"101","author":"Bourne","year":"1994","journal-title":"Ophthalmology"},{"key":"2025101810132505000_11.9.e050992.13","unstructured":"Alcon Research, LTD . 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