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Endothelial alterations in 712 keratoconus patients.
Susanne Goebels1, Timo Eppig2, Berthold Seitz1
1Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany.
Acta Ophthalmologica
|June 10, 2017
Summary
Keratoconus severity significantly impacts corneal endothelial cells, decreasing density and increasing variation with disease progression. Rigid contact lens wear also increases endothelial cell variation compared to no lens wear.
Area of Science:
- Ophthalmology
- Corneal Science
- Cell Biology
Background:
- Keratoconus is a progressive corneal ectasia affecting corneal structure.
- The corneal endothelium plays a vital role in maintaining corneal clarity and hydration.
- Understanding endothelial changes in keratoconus is crucial for patient management.
Purpose of the Study:
- To assess the relationship between keratoconus severity and corneal endothelial cell characteristics.
- To investigate the influence of contact lens wear on the corneal endothelium in keratoconus patients.
Main Methods:
- Retrospective analysis of 712 eyes from the Homburg Keratoconus Center database.
- Specular microscopy (Tomey EM-3000) for endothelial evaluation.
- Topographic and tomographic data from Scheimpflug imaging (Oculus Pentacam HR) used for classification (TKC stages 0-4).
Main Results:
- Endothelial cell density (ECD) significantly decreased (p < 0.001) and coefficient of variation (CV) significantly increased (p < 0.001) with advancing keratoconus stages (TKC 0-4).
- Eyes wearing rigid contact lenses (RCL) showed a significantly higher CV compared to eyes without contact lens wear (NoCL) (p = 0.02).
- No significant difference in ECD was observed between groups based on contact lens wear (NoCL, RCL, soft CL).
Conclusions:
- Corneal endothelial cell density declines, and cell size variation increases with keratoconus severity.
- Rigid contact lens wear is associated with increased endothelial cell size variation, independent of keratoconus stage.
