The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

2020 ◽  
Vol 63 (6) ◽  
pp. 550-554
Author(s):  
Panagiota Papadakou ◽  
Irini Chatziralli ◽  
Miltiadis Papathanassiou ◽  
Vaia Lambadiari ◽  
Charalambos S. Siganos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Endothelium ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Corneal Endothelial Cells ◽  
Factors Affecting

<b><i>Purpose:</i></b> The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. <b><i>Methods:</i></b> Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. <b><i>Results:</i></b> Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm<sup>2</sup>, respectively; <i>p</i> &#x3c; 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (<i>p</i> &#x3c; 0.001), longer DM duration (<i>p</i> = 0.003), and more severe diabetic retinopathy status (<i>p</i> = 0.008). <b><i>Conclusion:</i></b> DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.

scholarly journals The Effect of Phacoemulsification on Corneal Endothelial Cells Morphology and Thickness

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Abd Elaziz Mohamed Elmadina ◽  
Raghda Faisal Abdelfatah ◽  
Saif Hassan Alrasheed ◽  
Mustafa Abdu ◽  
Manzoor Ahmad Qureshi
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Endothelium ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
P Value ◽  
Corneal Endothelial Cells ◽  
Before And After

Purpose:  To compare the corneal endothelial cells morphology and central corneal thickness (CCT) before and after phacoemulsification in Sudanese population. Place and Duration of Study:  Al-Neelain eye hospital, Khartoum, Sudan, from January 2018 to May 2018. Study Design:  Observational longitudinal study. Methods:  One hundred and forty eyes of 140 patients with immature senile cataract were selected by convenient sampling. The age ranged from 40 to 85 years. The patients underwent complete ocular examination including morphology of corneal endothelial cells and CCT using computerized non-contact specular microscope. Inclusion criteria for the study was eyes with normal corneal endothelial cells and cell density more than 1000 cells/mm2. We excluded patients with ocular or systemic diseases, previous history of intraocular surgery, refractive surgery or trauma as well as contact lenses wear. The patients underwent phacoemulsification by a single surgeon. The examination parameters were repeated one month after surgery. Descriptive and comparative statistical analyses were performed using SPSS for Windows Version 21.0. Results:  There was significant reduction in mean endothelial cells density after phacoemulsification compared to baseline with p < 0.001. There was also significant post-operative reduction in mean endothelial cells number as compared to baseline (P value < 0.001). Mean endothelial cells hexagonality was reduced after surgery with P value of 0.003. No significant difference was found between mean coefficient variation of endothelial cells size before and after phacoemulsification (P = 0.55). Central corneal thickness showed significant increase post-operatively, P = 0.003. Conclusion:  Phacoemulsification causes significant damage to corneal endothelium cells, including decrease in corneal endothelial cell density, hexagonality and cell number. Key Words:  Corneal endothelium, Endothelial cell density, Central corneal thickness, Phacoemulsification.

Endothelial Cell Density and Central Corneal Thickness following Penetrating Keratoplasty of Acanthamoeba Keratitis Patients – A Retrospective Cross-Sectional Observational Study

2021 ◽  
Author(s):  
Lei Shi ◽  
Fabian Norbert Fries ◽  
Kassandra Xanthopoulou ◽  
Tanja Stachon ◽  
Loay Daas ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Observational Study ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Acanthamoeba Keratitis ◽  
Endothelial Cell Density ◽  
Cross Sectional ◽  
Time Point

Abstract Purpose To analyze endothelial cell density (ECD) and central corneal thickness (CCT) following penetrating keratoplasty (PKP) in Acanthamoeba keratitis (AK) patients. Patients and Methods In this retrospective, clinical, single-center, cross-sectional, observational study, patients were enrolled who underwent PKP at the Department of Ophthalmology of Saarland University Medical Center, Homburg/Saar, Germany between May 2008 and December 2016 with the diagnosis of AK. In all, 33 eyes of 33 patients (14 males, 42%) were enrolled; their mean age at the time of surgery was 39.5 ± 14.3 years. Postoperatively, AK patients received topical polyhexamethylene biguanide, propamidine isethionate, neomycin sulphate/gramicidin/polymixin B sulfate, and prednisolone acetate eye drops (5 ×/day each), and the topical treatment was tapered sequentially with 1 drop every 6 weeks over 6 months. CCT was recorded using Pentacam HR Scheimpflug tomography and ECD with the EM-3000 specular microscope before surgery and 3 and 6 months after surgery as well as after the first and second (complete) suture removal. Results ECD tended to decrease significantly from the time point before surgery (2232 ± 296 cells/mm2) to the time point 3 months after surgery (1914 ± 164 cells/mm2; p = 0.080) and to the time point after the first suture removal (1886 ± 557 cells/mm2; p = 0.066) and decrease significantly to the time point after the second suture removal (1650 ± 446 cells/mm2; p = 0.028). CCT did not change significantly over the analyzed time period (p ≥ 0.475). Conclusion In AK, endothelial cell loss does not seem to be accelerated following PKP, despite the postoperative use of diamidine and biguanide. A subsequent prospective comparative study should confirm our retrospective longitudinal analysis.

scholarly journals Corneal thickness and endothelial cell density in diabetic and non- diabetic patients: a hospital based comparative study

2018 ◽  
Vol 5 (3) ◽  
pp. 694 ◽  
Author(s):  
Nagaraj G. ◽  
Anasuya Sangaraj Desai ◽  
Nagesh Jayaram
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Specular Microscopy ◽  
The Mean

Background: Diabetes mellitus is associated with structural changes in corneal endothelial cells and their thickness. The present study was done to compare the endothelial cell density (ECD), central corneal thickness (CCT) and morphology in diabetic and non-diabetic patients.Methods: A cross-sectional study was conducted at Minto Ophthalmic hospital, BMC and RI Bangalore for a period of 20 months (October 2013 - May 2015). A total of 200 study subjects, 100 diabetics and 100 non-diabetic age matched controls were selected, and complete timed ophthalmic evaluation was performed. Specular microscopy was performed on all patients for endothelial cell count assessment and corneal thickness was measured by Pachymeter. The data was analyzed and represented using descriptive statistics. ‘t’ test was used for comparing the two groups.Results: The mean endothelial cell density in diabetic group was significantly lower (2438.73±250.23cells/mm2) compared to non-diabetic group (2599.88±168.16cells/mm2) (p<0.0001). The mean Central corneal thickness in diabetic group was significantly higher (518.40±28.13 μm) compared to control group (490.14±24.31 μm) (p<0.001). The Co-efficient of variation percentage of the diabetics was higher than the non-diabetics but this difference was not statistically significant (P>0.05). The hexagonality percentage was significantly lower in diabetic group compared to the controls suggesting less pleomorphism in the diabetic group.Conclusions: The study concludes that the endothelial cell density was lower and central corneal thickness was higher in diabetic patients compared with the non-diabetics. The altered endothelial morphology was significantly seen in the form of pleomorphism (hexagonality) but polymegathism was not significantly altered.

scholarly journals Corneal Thickness and Endothelial Morphology in Normal Thai Eyes

2020 ◽  
Author(s):  
Napaporn Tananuvat ◽  
Natawan Khumchoo
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Age Groups ◽  
Inverse Correlation ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Specular Microscopy ◽  
The Mean

Abstract Background: This study aimed to determine the influence of age on central corneal thickness and corneal endothelial morphology as well as to identify the relationship between them in normal Thai eyes.Methods: Non-contact specular microscopy was performed in volunteers stratified into seven age groups ranging from 11-88 years. The corneal endothelial parameters studied included central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation in cell size (CV), cell area (CA) and percentage of regular hexagonal cells.Results: In a total of 501 subjects (1002 eyes), the mean age was 43.12 ± 18.80 years and 347(69.3%) were females. The mean CCT, ECD, CV, CA, and hexagonality was 533.80 ± 33.00 μm, 2,732±258 cell/mm2, 37.61 ± 6.76%, 369.04 ± 37.90 mm, and 49.03% ± 7.53%, respectively. There was a statistically significant inverse correlation between age and CCT (r = -0.212, P <0.001), ECD (r = -0.484, P <0.001), and hexagonality (r = -0.193, P <0.001). The estimate rate of endothelial cell loss was 0.2% per year, whereas CV and CA had statistically significant correlation with age (r = 0.200, P <0.001 and r = 0.475, P <0.001). CCT correlated directly with ECD (r = 0.177, P <0.001).Conclusion: Normative data for corneal endothelial morphology in healthy Thai eyes showed that ECD, CCT, and hexagonality were significantly decreased, while CV and CA were increased with aging. The central corneal thickness was correlated with the endothelial cell density.

scholarly journals Study of Changes in Corneal Thickness and Corneal Endothelial Cell Density after Phacoemulsification Cataract Surgery

2021 ◽  
Vol 10 (12) ◽  
pp. 866-872
Author(s):  
Rajiv Pardasani ◽  
Sohan Lohiya
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Coefficient Of Variation ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
P Value ◽  
Corneal Endothelial Cell Density

BACKGROUND Phacoemulsification is a common surgery for cataract. The endothelium comprises of hexagonal cells which in single layer is essential for maintaining the transparency of the cornea. We wanted to compare endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variability, and hexagonality of endothelial cells before and after phacoemulsification surgery. we also wanted to evaluate the endothelial cell loss after phacoemulsification surgery. METHODS A rural hospital-based prospective observational study with 120 patients was conducted in a hospital based setting utilising the data of patient’s eye by considering inclusion and exclusion criteria, before and after phacoemulsification surgery by using noncontact specular microscope. RESULTS The mean endothelial cell density significantly decreased postoperatively at day one, 4th week, 12th week. The mean central corneal thickness increased significantly at postoperative day one, then subsequently decreased at postoperative 4th week and 12th week (P value = 0.0001), but never reached the preoperative value. There was a significant change in coefficient of variation and hexagonality postoperatively (P value = 0.0001). CONCLUSIONS The primary result is the change in corneal endothelial cell density (cells per square millimetre of the corneal surface) which is decreased, and the central corneal thickness calculated in micro meter is increased. As endothelial cells do not replicate, to reimburse cell loss there are changes in coefficient of variation and hexagonality after phacoemulsification surgery. KEY WORDS Corneal Endothelial Cell Density, Central Corneal Thickness, Coefficient of Variation, Hexagonality, Phacoemulsification, Specular Microscope

scholarly journals Evaluation of the Endothelial Cell Density and the Central Corneal Thickness in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Bożydar T. Tomaszewski ◽  
Renata Zalewska ◽  
Zofia Mariak
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
Specular Microscopy ◽  
Pseudoexfoliation Glaucoma ◽  
And Control

Purpose.Evaluation of central corneal thickness (CCT) and endothelial cell density (ECD) in patients with senile cataract and coexisting pseudoexfoliation (PEX) syndrome with glaucoma (PEXG) and without glaucoma using specular microscopy.Participants and Methods.The study included 122 patients (217 eyes). In this group of patients we identified 133 eyes with PEX syndrome (65 with glaucoma, 68 without glaucoma) and 84 eyes without PEX syndrome. ECD and CCT were measured in each eye by specular microscopy.Results.ECD in eyes with PEX syndrome without glaucoma (2297 ± 359 cell/mm2) and in eyes with PEXG (2241 ± 363 cell/mm2) was lower than in the control group (2503 ± 262 cell/mm2) (P<0.001). CCT in eyes with PEXG (508.2 ± 32.6 μm) was thinner than in eyes with PEX syndrome without glaucoma (529.7 ± 30.3 μm) and control group (527.7 ± 29.4 μm) (P<0.001).Conclusions.This research shows that in eyes with PEX syndrome, both with and without glaucoma, ECD was statistically significantly lower than in the control group. In patients with PEXG, CCT was statistically significantly thinner than in the PEX syndrome and control group.

scholarly journals Comparison of endothelial/Descemet’s membrane complex thickness with endothelial cell density for the diagnosis of corneal transplant rejection

2018 ◽  
Vol 10 ◽  
pp. 251584141881418 ◽  
Author(s):  
Christopher Smith ◽  
Daniel Kaitis ◽  
Jordan Winegar ◽  
Sean Edelstein ◽  
Matthew Council ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Endothelial Cell Density ◽  
High Definition ◽  
Membrane Complex ◽  
Descemet's Membrane ◽  
Descemet’S Membrane

Purpose: This study compared the effectiveness of endothelial/Descemet’s membrane complex thickness obtained using high-definition anterior segment optical coherence tomography with endothelial cell density obtained using confocal microscopy as diagnostic tools in predicting corneal transplant rejection. Methods: This observational, prospective, cross-sectional study evaluated penetrating keratoplasty grafts. Slit lamp examination organized the grafts into healthy or rejecting grafts. Grafts were scanned using both high-definition anterior segment optical coherence tomography and confocal microscopy. Central corneal thickness, endothelial/Descemet’s membrane complex thickness, endothelial cell density, and coefficient of variation were each compared with the clinical status. Descemet’s rejection index, defined by endothelial/Descemet’s membrane complex thickness divided by central corneal thickness multiplied by 33, further compared endothelial/Descemet’s membrane complex thickness with central corneal thickness. Results: Endothelial/Descemet’s membrane complex thickness, central corneal thickness, and Descemet’s rejection index were all able to differentiate between clear and rejected corneal grafts ( p < 0.0001, p = 0.001, and p = 0.012, respectively). Endothelial cell density and coefficient of variation did not correlate with the clinical status ( p = 0.054 and p = 0.102, respectively). Endothelial/Descemet’s membrane complex thickness had the largest area under the curve using receiver operating characteristic curves ( p < 0.0001). Endothelial/Descemet’s membrane complex thickness had a sensitivity of 86% and specificity of 81% with a cutoff value of >16.0 µm ( p < 0.0001). The sensitivity and specificity of endothelial cell density were both 71% with a cutoff value of ⩽897 cells/mm2 ( p = 0.053). There was a high correlation between endothelial/Descemet’s membrane complex thickness and both Descemet’s rejection index and central corneal thickness ( p < 0.0001). Conclusion: Endothelial/Descemet’s membrane complex thickness measured by high-definition anterior segment optical coherence tomography is a useful parameter for the diagnosis of corneal graft rejection. The diagnostic performance of endothelial/Descemet’s membrane complex thickness was significantly better than that of endothelial cell density and central corneal thickness. Endothelial cell density and the coefficient of variation were unable to diagnose corneal graft rejection in our cross-sectional study.

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