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Endothelial cell density and morphology in keratoconus

Poster Details

First Author: Y.Lantigua Dorville SPAIN

Co Author(s):    V. De Juan   D. Peña   D. Galarreta        

Abstract Details


To determine if there are any differences in corneal endothelial cell density and morphology between keratoconic and healthy eyes in central and peripheral corneal measurements by specular microscopy.


University Clinic Hospital of Valladolid, Valladolid, Spain.


Cross-sectional study that included 60 eyes of 60 patients (30 keratoconic eyes -mean age 35.7ḟ7.6 years- and 30 healthy eyes - mean age 32.1ḟ7.2 years-). Exclusion criteria included corneal opacities, previous ocular surgery or trauma, increased intraocular pressure, uveitis and endothelial dystrophy. Diagnosis of keratoconus was made by corneal topography according to Rabinowitz criteria and clinical findings on slit-lamp examination. All subjects underwent corneal elevation topography (Galillei G2; Ziemer) to localize the apex cone, and a noncontact specular microscopy (SP-3000P; Topcon). Patients must have an inferior-temporal location of the cone to be included. Mean endothelial cell density (MCD), percentage of coefficient of variation in cell area (CV), and percentage of hexagonality in cell area (PH) were measured in central cornea and in 4 predetermined peripheral areas (inferior, superior, nasal, temporal). Additionally, a manual-centered measurement in the inferior-temporal cornea was performed.


All the predetermined measurements by specular microscopy (central, inferior, superior, temporal and nasal) showed no statistical significant differences between keratoconus and control group in Central: [MCD (2795.9ḟ382.8 vs. 2939.6ḟ284.2 cells/mm2, p=0.104), CV (34.1ḟ5.1 vs. 36.1ḟ5.5 %, p=0.161) and PH (56.2ḟ10.8 vs. 55.5ḟ10.6 %, p=0.811)], Superior: [MCD (3124.7ḟ429.1 vs. 3212.9ḟ396.6 cells/mm2, p=0.415), CV (36.7ḟ8.1 vs. 37.7ḟ6.4 %, p=0.586) and PH (52.4ḟ15.7 vs. 53.4ḟ13.9 %, p=0.808)], Inferior: [MCD (2864.2ḟ358.5 vs. 2972.5ḟ330.6 cells/mm2, p=0.232), CV (36.7ḟ6.9 vs. 36.4ḟ4.5 % (p=0.875) and PH (52.6ḟ10.9 % vs. 56.3ḟ8.0 %, p=0.137)], Nasal: [MCD (3051.1ḟ338.8 vs. 3024.2ḟ287.7 cells/mm2 ,p=0.742), CV (36.9ḟ7.4 vs. 35.8ḟ4.1 %, p=0.494) and PH (55.3ḟ13.3 vs. 57.5ḟ10.5 %, p=0.466)], and Temporal area: [MCD (2993.2ḟ349.9 vs. 3064.4ḟ352.7 cells/mm2, p=0.436), CV (38.4ḟ8.9 vs. 38.2ḟ6.3 % ,p=0.925) and PH (49.6 ±14.2 vs. 55.0 ±11.8 %, p=0.115)]. Manually centered inferior-temporal area showed no differences between keratoconic and healthy eyes in MCD: 2982.4ḟ357.7 vs. 2936.9ḟ273.9 cells/mm2 (p=0.587), and CV: 37.4ḟ7.1 vs. 36.3ḟ4.1 % (p=0.465). However, PH was statistically significant lower in keratoconus patients [50.4ḟ11.1 vs. 56.2ḟ11.2 % (p=0.037)].


Endothelium in keratoconus is similar to normal corneas. Endothelium in cone area has different percentage of hexagonality, maybe due to possible distortion strength. Manual location of the cone measurement limits the conclusions.

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