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Endothelial alterations in 712 keratoconus patients

Goebels, Susanne; Eppig, Timo; Seitz, Berthold; Szentmàry, Nòra; Cayless, Alan and Langenbucher, Achim (2017). Endothelial alterations in 712 keratoconus patients. Acta Ophthalmologica, 96(2) e134-e139.

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DOI (Digital Object Identifier) Link: https://doi.org/10.1111/aos.13471
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Abstract

Purpose
To investigate the effect of the severity of keratoconus on the corneal endothelium using specular microscopy.
Methods
Seven hundred and twelve eyes from the Homburg Keratoconus Center (HKC) database were included in this retrospective study. Corneal endothelium was evaluated using the Tomey EM-3000 specular microscope. Keratoconus-related topographic and tomographic data were obtained from Scheimpflug-based tomography (Oculus Pentacam® HR). Eyes were classified into stages 0 (healthy) to 4 (severe keratoconus) according to the Topographic Keratoconus Classification (TKC). Subgroups were analysed based on contact lens (CL) type (none/rigid/soft).
Results
The frequencies of keratoconus stages 0/1/2/3/4 according to TKC were 169/94/206/166/77. The endothelial cell density (ECD) for the endothelial cell area for TKC 0/1/2/3/4 was 2611/2624/2557/2487/2401 cells per mm2 and the coefficient of variation (CV) was 40.9/40.0/41.6/46.2/49.0%, respectively. The more severe the keratoconus stage, the lower the endothelial cell count (p < 0.001) and the higher the CV (p < 0.001). No contact lens wearing was noted in 207 eyes (NoCL), rigid CL in 200 (RCL) and soft CL in 54 (SCL). CD for NoCL/RCL/SCL was 2523/2533/2644 per mm2 and CV was 41.8/54.1/43.1%, respectively. A significant difference in CV was found between NoCL and RCL (p = 0.02), and no significant difference in CV was found between NoCL and SCL (p = 0.07). Endothelial cell density (ECD) did not differ significantly between NoCL and RCL or SCL.
Conclusion
Endothelial cell density (ECD) decreases and CV increases significantly with increasing tomographic severity of keratoconus. In patients with RCL compared to eyes without CL wear, we found a statistically significantly higher CV in the endothelial cell size.

Item Type: Journal Item
Copyright Holders: 2017 Acta Ophthalmologica Scandinavica Foundation
ISSN: 1755-3768
Keywords: contact lens; corneal endothelium; EM-3000; keratoconus; specular microscopy
Academic Unit/School: Faculty of Science, Technology, Engineering and Mathematics (STEM) > Physical Sciences
Faculty of Science, Technology, Engineering and Mathematics (STEM)
Item ID: 50007
Depositing User: Alan Cayless
Date Deposited: 07 Jul 2017 13:43
Last Modified: 16 Oct 2018 17:44
URI: http://oro.open.ac.uk/id/eprint/50007
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