Correlation of full-thickness corneal wound length with endothelial cell loss

We studied 12 patients who had sustained penetrating corneal lacerations with corneal wound lengths ranging from 1 to 9 mm to determine whether wound size was directly proportional to endothelial cell loss 3 or more months after injury. Endothelial cell counts in the uninjured eye averaged 2973 +/- 330 cells/mm2 (range, 2500 to 3700). In the injured eye, near the wound (less than 2 mm from the wound), the cell counts averaged 1260 +/- 590 cells/mm2 (range, 575 to 2500); away from the wound, where cells appeared healthiest, counts averaged 1619 +/- 544 cells/mm2 (range, 850 to 2750). The average total cell loss near the wound was 1713 +/- 622 cells/mm2 (range, 500 to 2575), vs 1354 +/- 582 cells/mm2 (range, 250 to 2150) away from the wound, compared with the uninjured eye. Cell loss near the wound was not significantly different from that away from the wound. There was a positive correlation between wound length and total cell loss measured both near the wound (r = 0.830) and away from the wound (r = 0.755). Pars plana lensectomy was not associated with detectable additional cell loss. Our results suggest that patients with corneal lacerations sustain significant endothelial cell loss, which correlates closely with wound length, and that patients with larger wounds may be at greater risk for developing corneal decompensation with additional procedures or trauma.