Changes in Central Corneal Thickness and Corneal Endothelial Morphology in Contact Lens-Wearing Diabetic Patients

Joon Won Kang; Ki Cheul Shin

doi:10.3341/jkos.2014.55.10.1426

Journal List > J Korean Ophthalmol Soc > v.55(10) > 1009799

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Kang and Shin: Changes in Central Corneal Thickness and Corneal Endothelial Morphology in Contact Lens-Wearing Diabetic Patients

Original Article

J Korean Ophthalmol Soc 2014;55(10):1426-1431.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.10.1426

Changes in Central Corneal Thickness and Corneal Endothelial Morphology in Contact Lens-Wearing Diabetic Patients

Joon Won Kang, MD, Ki Cheul Shin, MD, PhD

Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

Address reprint requests to Ki Cheul Shin, MD, PhD, Department of Ophthalmology, Konkuk University Medical Center, #120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea, Tel: 82-2-2030-8180, Fax: 82-2-2030-5273 E-mail: 20050129@kuh.ac.kr

Received 26 April 2014 Revised 9 June 2014 Accepted 3 October 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the changes in central corneal thickness and corneal endothelium in contact lens-wearing diabetic patients.

Methods

This study included 113 patients who visited the Department of Ophthalmology, Konkuk University Medical Center from August 2006 to August 2007. Ultrasound pachymetry and noncontact specular microscopy were performed on the right eyes of 26 diabetic patients who regularly wore soft contact lenses (group 1), 27 diabetic patients who did not wear soft contact lenses (group 2), 30 soft contact lens-wearers without diabetes mellitus (DM) (group 3), and 30 normal subjects who did not wear soft contact lenses (group 4). Central corneal thickness, corneal endothelial cell density, endothelial cell coefficient of variation, and percentage of hexagonal endothelial cells were compared between the groups.

Results

Average duration of diabetes in groups 1 and 2 was 4.38 and 4.41 years, respectively, and average duration of soft contact lens wear in groups 1 and 3 was 5.27 and 3.65 years, respectively. The central cornea was significantly thicker and the endothelial cell density was significantly lower in group 1 than in groups 3 and 4. The cell size coefficient of variation was higher in group 1 than in groups 2 and 4 and higher in group 3 than in group 4. The percentage of hexagonal cells was significantly lower in group 3 than in group 4.

Conclusions

Central corneal thickness and endothelial cell density are more affected by DM than contact lens use, and corneal endothelial cell morphology is influenced more by contact lens use than DM. Contact lens use in diabetic patients significantly influences all characteristics of the corneal endothelium compared with those in normal subjects. Patients with DM should be advised not to wear contact lenses.

Keywords: Contact lens, Corneal endothelial cell, Corneal thickness, Diabetes mellitus

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Table 1.

Baseline characteristics

	Group 1 (DM/CL)	Group 2 (DM)	Group 3 (CL)	Group 4 (control)
	(n = 26)	(n = 27)	(n = 30)	(n = 30)
Age (years)	31.88 ± 3.39	30.00 ± 3.34	28.00 ± 7.20	28.00 ± 5.61
Sex (M:F)	14:12	14:13	15:15	17:13
Spherical equivalent (D)	−4.56 ± 1.65	−4.29 ± 1.50	−4.68 ± 2.42	−4.02 ± 2.27
Duration of DM (years)	4.38 ± 1.50	4.41 ± 1.45	−	−
Duration of CL wear (years)	5.27 ± 1.76	−	3.65 ± 2.69	−

Values are presented as mean ± SD unless otherwise indicated.

DM = diabetes mellitus; CL = contact lens; D = diopter.

Table 2.

Central corneal thickness and endothelial cell morphology

	Group 1 (DM/CL)	Group 2 (DM)	Group 3 (CL)	Group 4 (control)
	(n = 26)	(n = 27)	(n = 30)	(n = 30)
Central corneal thickness (μm)	566.35 ± 35.99	553.59 ± 45.80	542.10 ± 35.29	534.13 ± 26.31
Corneal endothelial cell density (cells/mm²)	2904.81 ± 236.42	2967.15 ± 540.15	3218.30 ± 376.54	3385.143 ± 275.92
Coefficient of variation	0.37 ± 0.04	0.33 ± 0.04	0.35 ± 0.04	0.32 ± 0.05
Hexagonality (%)	58.88 ± 5.28	63.89 ± 8.61	61.27 ± 4.67	66.07 ± 9.93

Values are presented as mean ± SD.

DM = diabetes mellitus; CL = contact lens.

Table 3.

Analysis of central corneal thickness and endothelial cell morphology (p-value)

	Group	Group	Group	Group	Group	Group
	1 vs. 2	1 vs. 3	1 vs. 4	2 vs. 3	2 vs. 4	3 vs. 4
Central corneal thickness (μm)	0.393	0.014^*	0.003^*	0.164	0.083	0.326
Corneal endothelial cell density (cells/mm²)	0.302	0.001^*	<0.001^*	0.106	0.004^*	0.055
Coefficient of variation	0.003^*	0.015^*	<0.001^*	0.228	0.275	0.011^*
Hexagonality (%)	0.065	0.079	0.003^*	0.476	0.405	0.020^*

^* Mann-Whitney test, p-value < 0.05, statistically significant difference.

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