• angle-closure glaucoma
• cornea
• in vivo confocal microscopy
• morphological characteristics

• Fuchs’ uveitis syndrome
• corneal endothelium
• non-contact specular microscopy

• Humans
• Female
• Male
• Endothelium, Corneal/pathology
• Middle Aged
• Adult
• China/epidemiology
• Cell Count
• Aged
• Retrospective Studies
• Young Adult
• Intraocular Pressure/physiology
• Corneal Endothelial Cell Loss/diagnosis
• Cell Size
• Asian People/ethnology
• East Asian People

• Acute angle closure
• COVID-19
• Daily activity

• Humans
• COVID-19/epidemiology
• COVID-19/complications
• Female
• Glaucoma, Angle-Closure/physiopathology
• Glaucoma, Angle-Closure/epidemiology
• Male
• Middle Aged
• Aged
• China/epidemiology
• Activities of Daily Living
• SARS-CoV-2
• Acute Disease
• Intraocular Pressure/physiology
• Surveys and Questionnaires

• 20-205-4-042 Shenyang Science and Technology Bureau
• 2022C03112 The Key R&D Program of Zhejiang
• No. 2021R52012 The Program for Zhejiang Leading Talent of S&T Innovation

• Cataract
• Corneal endothelial cells
• Surgical treatment

• Corneal endothelial cell
• Descemet membrane endothelial keratoplasty
• Intraocular pressure elevation
• Ocular hypertension

• Humans
• Descemet Stripping Endothelial Keratoplasty/methods
• Female
• Male
• Intraocular Pressure/physiology
• Aged
• Middle Aged
• Visual Acuity/physiology
• Endothelium, Corneal/pathology
• Glaucoma/surgery
• Glaucoma/physiopathology
• Retrospective Studies
• Postoperative Complications
• Aged, 80 and over
• Follow-Up Studies
• Graft Survival/physiology
• Cell Count
• Ocular Hypertension/physiopathology
• Postoperative Period
• Adult
• Corneal Diseases/surgery
• Corneal Diseases/physiopathology
• Corneal Endothelial Cell Loss/diagnosis
• Corneal Endothelial Cell Loss/physiopathology

• Humans
• Glaucoma, Angle-Closure/diagnosis
• Glaucoma, Angle-Closure/physiopathology
• Cross-Sectional Studies
• Limbus Corneae/pathology
• Limbus Corneae/diagnostic imaging
• Male
• Female
• Middle Aged
• Anterior Chamber/diagnostic imaging
• Anterior Chamber/pathology
• Microscopy, Acoustic
• Cell Count
• Microscopy, Confocal
• Aged
• Stem Cells/pathology
• Intraocular Pressure/physiology
• Gonioscopy
• Limbal Stem Cell Deficiency

• Humans
• Endothelium, Corneal
• Cross-Sectional Studies
• Anterior Chamber
• Inflammation
• Correlation of Data

• Acute angle closure
• Corneal damage
• Corneal endothelium
• Endothelial cell density

• Humans
• Acute Disease
• East Asian People
• Glaucoma, Angle-Closure/complications
• Glaucoma, Angle-Closure/pathology
• Intraocular Pressure
• Retrospective Studies
• Treatment Outcome
• Endothelium, Corneal/injuries
• Endothelium, Corneal/pathology

• 2016-2-1081 Capital Health Research and Development of Special Fund
• 82171049 National Natural Science Foundation of China

The corneal endothelium has a crucial role in maintaining a clear and healthy cornea. Corneal endothelial cell loss occurs naturally with age; however, a diagnosis of glaucoma and surgical intervention for glaucoma can exacerbate a decline in cell number and impairment in morphology. In glaucoma, the mechanisms for this are not well understood and this accelerated cell loss can result in corneal decompensation. Given the high prevalence of glaucoma worldwide, this review aims to explore the abnormalities observed in the corneal endothelium in differing glaucoma phenotypes and glaucoma therapies (medical or surgical including with new generation microinvasive glaucoma surgeries). Descemet membrane endothelial keratoplasty (DMEK) is increasingly being used to manage corneal endothelial failure for glaucoma patients and we aim to review the recent literature evaluating the use of this technique in this clinical scenario.

• Acute angle-closure crisis
• Confocal microscopy
• Cornea

• Cell Count
• Cornea/diagnostic imaging
• Corneal Edema
• Cross-Sectional Studies
• Endothelial Cells
• Humans
• Microscopy, Confocal

• physical examination
• optic nerve diseases

• acute angle closure crisis
• cornea endothelial cells
• diabetic keratopathy
• intraocular hypertension
• type 2 diabetes mellitus

• Acute Disease
• Aged
• Blood Glucose
• Cell Count
• Diabetes Mellitus, Type 2/complications
• Endothelial Cells
• Endothelium, Corneal
• Female
• Humans
• Male
• Middle Aged

• National Natural Science Foundation of China
• Natural Science Foundation of Shandong Province

• Endothelial Cells
• Glaucoma Drainage Implants
• Glaucoma, Open-Angle/surgery
• Humans
• Intraocular Pressure
• Italy/epidemiology
• Phacoemulsification
• Prospective Studies
• Registries
• Treatment Outcome

• Biomechanics
• Corneal endothelial cell
• Corneal endothelium
• Descemet's membrane
• Extracellular matrix
• Tissue engineering

Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT.

In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis.

A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was − 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was − 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001).

We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.

The online version contains supplementary material available at 10.1186/s12886-021-01908-4.

• Central corneal thickness
• Corneal biomechanics
• Glaucoma
• Glaucoma management
• Primary angle-closure

• Anterior Chamber/diagnostic imaging
• Anterior Chamber/surgery
• Cataract/complications
• Female
• Follow-Up Studies
• Glaucoma, Angle-Closure/complications
• Glaucoma, Angle-Closure/physiopathology
• Glaucoma, Angle-Closure/surgery
• Gonioscopy
• Humans
• Intraocular Pressure/physiology
• Iris/surgery
• Lens Implantation, Intraocular/methods
• Male
• Middle Aged
• Phacoemulsification/methods
• Prospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Visual Acuity

To investigate demographic and anatomical factors associated with a reduction in endothelial cell density (ECD) after phacoemulsification (PE) for the treatment of primary angle closure (PAC).

In this prospective case series, ECD was evaluated by noncontact specular microscopy and biometric parameters by both noncontact optical biometry and anterior segment optical coherence tomography, preoperatively and at 12 months after surgery. Anterior segment biomicroscopy and gonioscopy were also performed. The change in ECD and its relation to clinical characteristics and biometric parameters were evaluated by linear regression analysis.

44 patients with PAC were included in the study. The mean (SD) patient age was 71.6 (10.2) years; thirty-one (70.5%) of them were women. Coexistence of exfoliation syndrome (XS) was observed in 4 cases (9.1%). The mean (SD) ECD (cells/mm²) changed from 2275 (463) preoperatively to 1964 (613) postoperatively with a mean reduction of −310 (95% CI −445 to −176; p < 0.001). In the multivariate regression model, after correction for age and lens status, XS was the only parameter associated with ECD percentage change (B = −36.00; p=0.001).

PE in angle closure causes a significant ECD reduction. In our population of PAC patients, XS is significantly associated with ECD change. In this group of patients, a careful preoperative endothelial evaluation should be performed.

Glaucoma is a group of diseases characterized by a specific pattern of optic nerve neuropathy and retinopathy. Increasing evidence demonstrates glaucoma associated corneal endothelium loss. Direct-compression mechanism due to elevated intraocular pressure (IOP), cell toxicity after long term exposure to preservatives and glaucoma surgery have been reported to be the possible mechanism. Herein, we compare the specular endothelial microscopy in primary open-angle glaucoma (POAG) patients and healthy controls of the same age group to observe the corneal endothelium changes and the correlations to the mean IOP in a Chinese case control study.

To investigate corneal endothelial cell density in Chinese patients with POAG.

A case control study was performed on 60 eyes of 60 patients with POAG. Exclusion criteria included history of corneal diseases, intraocular diseases, contact lens use, ocular trauma or surgery (including intraocular surgery and laser treatment), congenital abnormalities or systemic diseases such as diabetes. Intraocular pressure was measured using Goldmann tonometry. Indirect specular microscopy (TOPCON SP-2000P) was performed on central corneas and endothelial images were acquired. Endothelial cell density, area and cell counts were analyzed.

Endothelial cell density was 2959 ± 236 cells/mm² in healthy controls and 2757 ± 262 cells/mm² in patients with POAG. The POAG eyes had significantly lower endothelial cell density compared to healthy control eyes (P < 0.001). In the POAG group, endothelial cell density was 2686 ± 233 cells/mm² in the patients receiving medication and 2856 ± 272 cells/mm² in the untreated subgroup. The eyes receiving medication had significantly lower endothelial cell density compared to untreated eyes. There was a negative correlation between cell density and mean IOP (r = −0.286, P = 0.004), positive correlation between the average cell area and mean IOP (r = 0.228, P = 0.022), maximum cell area and mean IOP (r = 0.218, P = 0.029) and minimum cell area and mean IOP (r = 0.290, P = 0.003). The percentage of hexagonal cells was not correlated with mean IOP.

Patients with POAG have lower corneal endothelial cell density than healthy controls of the same age. This may be attributed to mechanical damage from elevated IOP and toxicity of glaucoma medications.

• Corneal endothelium
• Primary open angle glaucoma
• Intraocular pressure

• Corneal endothelial cell count
• Fuchs uveitis syndrome
• Herpesviridae
• Posner–Schlossman syndrome
• cytomegalovirus
• glaucoma
• hypertensive anterior uveitis
• viral anterior uveitis

Phacoemulsification is the most commonly performed cataract surgery in this era. With all the recent advances in investigations and management of cataract through phacoemulsification, most of the patients are able to achieve excellent visual outcome. Corneal edema after phacoemulsification in the immediate postoperative period often leads to patient dissatisfaction and worsening of outcome. Delayed onset corneal edema often warrants endothelial keratoplasty. This review highlights the etiopathogenesis, risk factors, and management of corneal edema in the acute phase including descemet's membrane detachment (DMD) and toxic anterior segment syndrome. Various investigative modalities such as pachymetry, specular microscopy, anterior segment optical coherence tomography, and confocal microscopy have been discussed briefly.

• aqueous humor
• corneal endothelium
• glaucoma
• intraocular pressure
• keratoplasty

Acute ocular hypertension (AOH) frequently compromises corneal endothelial cell (CEC) function in clinical practice. This type of stress induces corneal oedema and a decrease in the corneal endothelial cell density (ECD). The anterior chamber of the right eye of Sprague-Dawley rats was irrigated with Balanced Salt Solution (BSS) for two hours, and the left eye served as a control to determine the time-dependent effects of AOH on endothelial cell morphology and function. The average intraocular pressure (IOP) increased to 82.6 ± 2.3 mmHg (normal range: 10.2 ± 0.4 mmHg) during anterior irrigation. Very soon after initiating irrigation, corneal oedema became evident and the cornea exhibited a significant increase in permeability to FITC-dextran. The peripheral ECD was significantly reduced, and the morphology of CECs became irregular and multiform. The structures of the zonula occludens-1 (ZO-1) and F-actin were severely disrupted. In addtion, Na,K-ATPase exhibited a dispersed expression pattern. Two days after irrigation, obvious CEC proliferation was observed, the ECD recovered to a normal level, and F-actin was dispersed throughout the cytoplasm. Seven days later, the CEC structure and function were nearly normalized. Based on the results obtained using this model, an acute IOP crisis exerts transient deleterious effects on CEC structure and function in rats.

Nanophthalmos, uveal effusion syndrome, and acute angle closure glaucoma (ACG) can present as a continuum in a patient, as is described here. This patient's angle closure was thought to be caused by idiopathic uveal effusion syndrome, and while there are no generally accepted diagnosis criteria for nanophthalmos, our patient fulfilled the criteria as defined by Wu.¹⁰ To prevent development of further angle closure, the decision was made to do cataract extraction as opposed to medical management.

• Angle closure glaucoma
• Cataract
• Glaucoma
• Nanonophthalmos
• Uveal effusion syndrome.

• corneal decompensation
• corneal endothelial cell count
• corneal endothelial cell density
• corneal endothelium
• laser iridotomy

• Humans
• Cell Count
• Corneal Edema/etiology
• Corneal Edema/physiopathology
• Endothelium, Corneal/physiopathology
• Iridectomy
• Iris/surgery
• Laser Therapy
• Risk Factors

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anterior Eye Segment/pathology
• Asian People
• Child
• Cohort Studies
• Electroretinography
• Family Health
• Female
• Glaucoma, Angle-Closure/diagnosis
• Gonioscopy
• Humans
• Intraocular Pressure
• Male
• Middle Aged
• Pedigree
• Phenotype
• Prospective Studies
• Young Adult