Published online Aug 6, 2019. doi: 10.12998/wjcc.v7.i15.1978
Peer-review started: April 12, 2019
First decision: May 31, 2019
Revised: June 28, 2019
Accepted: July 3, 2019
Article in press: July 4, 2019
Published online: August 6, 2019
The corneal endothelial monolayer maintains corneal clarity, and its damage is irreversible. Cornea endothelial cell loss is attributed to open-angle glaucoma, medicine and surgery treatments.
The main topic is the changes in corneal endothelial cell density in primary open-angle glaucoma (POAG) patients.
To investigate the corneal endothelium changes and the correlations to the mean intraocular pressure (IOP) in POAG patients.
Sixty POAG patients were selected as the patient group (32 male, 28 females; mean age 63 ± 13 years, age range 50-80 years). Meanwhile, 60 age-matched healthy controls who underwent physical examination were selected. IOP was measured by Goldmann tonometry. Corneal endothelial cell density, percentage of hexagonal cells, average cell area, maximum cell area, minimum cell area, standard deviation of cell area and coefficient of variation in cell area were measured by specular microscopy.
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) and 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.
For glaucoma patients, quantitative analysis of CEC morphology is necessary, and high IOP should be controlled as soon as possible to prevent corneal endothelial damage.
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.