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Noh, Lim, and Cha: Corneal Endothelial Cell Changes in Korean Patients with Exfoliation Syndrome
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(11): 1649-1656.

Published online: 19 November 2012

DOI: https://doi.org/10.3341/jkos.2012.53.11.1649

Corneal Endothelial Cell Changes in Korean Patients with Exfoliation Syndrome

Dong Hyoun Noh, MD, Su-Ho Lim, MD, Soon Cheol Cha, MD, PhD

Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.

Address reprint requests to Soon Cheol Cha, MD, PhD. Department of Ophthalmology, Yeungnam University Medical Center, #170 Hyeonchung-ro, Nam-gu, Daegu 705-717, Korea. Tel: 82-53-620-3442, Fax: 82-53-626-5936, sccha@med.yu.ac.kr

Received 30 April 2012       Accepted 27 September 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To compare the corneal endothelial cell changes in both eyes of Korean patients with clinically unilateral exfoliation syndrome using specular microscopy.

Methods

A total of 144 eyes of 72 patients diagnosed with clinically unilateral exfoliation syndrome at Yeungnam University Hospital between March 2000 and February 2011 were retrospectively reviewed. Comparisons of corneal morphometric analysis were made including endothelial cell density, coefficient of variation, hexagonality, and central corneal thickness between the exfoliative and fellow non-exfoliative eyes in 72 patients with naive unilateral exfoliation syndrome. If patients received intraocular surgery during the follow-up periods, the number of intraocular surgeries and changes of the above-mentioned morphometric analysis were evaluated.

Results

The paired exfoliative and fellow non-exfoliative eyes did not differ in endothelial cell density (2587.0 ± 391.0 vs. 2626.8 ± 354.6 cells/mm2, p = 0.321), in the coefficient of variation of cell size (35.9 ± 5.1 vs. 37.1 ± 4.7%), hexagonality (59.5 ± 7.3 vs. 57.8 ± 6.3%), and central corneal thickness (530.5 ± 37.6 vs. 532.0 ± 35.2 µm). However, the exfoliative eyes had significantly higher values for the number of intraocular surgeries (0.97 ± 0.78 vs. 0.28 ± 0.48, p < 0.001) and decrement of corneal endothelial cells (410.9 ± 538.7 vs. 19.0 ± 284.5 cells/mm2, p = 0.007).

Conclusions

There were no significant morphologic differences in corneal endothelium between exfoliative eyes and fellow eyes in the present study. However, the authors suggest that specular microscopic examination be performed before intraocular surgery in eyes with exfoliation syndrome when considering the higher frequency of intraocular surgeries and the resultant corneal endothelial damages observed in the present study.

Keywords: Cornea, Endothelium, Exfoliation syndrome, Specular microscopy

Figures and Tables

Table 1
Demographics and clinical characteristics in 72 patients with exfoliation syndrome
jkos-53-1649-i001

Values are presented as n (%) unless otherwise indicated.

XFS = exfoliative eye; non-XFS = fellow (non-exfoliative) eye.

Table 2
Findings in specular microscopy, pachymetry and number of intraocular surgery
jkos-53-1649-i002

Values are presented as mean ± SD unless otherwise indicated.

*p-value by paired t-test; †p-value by Pearson chi-square test.

XFS = exfoliative eye; Non-XFS = fellow (non-exfoliative) eye; PEA = phacoemulsification; PCL = posterior chamber lens implantation; ECCE = extracapsular cataract extraction; GDD = glaucoma drainage device.

Table 3
Distribution of eyes according to presence of glaucoma
jkos-53-1649-i003

XFS = exfoliative eye; Non-XFS = fellow (non-exfoliative) eye.

*p < 0.001 by Pearson chi-square test.

Table 4
Findings in specular microscopy and pachymetry according to presence of glaucoma
jkos-53-1649-i004

Values are presented as mean ± SD.

*p-value by Independent t-test.

Table 5
Number of intraocular surgery and changes of specular microscopic findings
jkos-53-1649-i005

Values are presented as mean ± SD.

XFS = exfoliative eye; Non-XFS = fellow (non-exfoliative) eye.

*(Pre-operative values) - (Post-operative values); †p-value by Wilcoxon rank sum test.

Table 6
Comparison of specular microscopic findings with the results of other studies
jkos-53-1649-i006

XFS = exfoliation syndrome; XFG = exfoliative glaucoma; ECD = endothelial cell density; NS = not significant; CV = coefficient of variation; N/A = not available.

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