CORNEAL ENDOTHELIAL CELL CHARACTERISTICS IN PATIENTS WITH DRY EYE DISEASE

This study aimed to evaluate corneal endothelial cell characteristics in patients with dry eye disease (DED) compared to an age- and gender-matched healthy control group.

Health Science University, Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey.

This Cross-sectional, controlled study included 59 eyes of 59 patients with moderate-to-severe dry eye disease (31 male, mean age 51.8 ± 6.2 years old) and 53 eyes of 53 normal controls (24 male, mean age 50.5 ± 6.9 years old). All individuals underwent a complete ophthalmic examination including symptom assessment using the Ocular Surface Disease Index (OSDI), corneal fluorescein staining,  and tear breakup time (TBUT). In vivo specular microscopy was performed to assess the following parameters in the central cornea: endothelial cell density, coefficient of variation, and hexagonality.

Endothelial cell density was significantly lower in patients with dry eye disease (2389.8 ± 279.3 cells/mm2) compared to the healthy controls (2556.8 ± 347.7 cells/mm2) (P=0.046). Coefficient of variation was significantly higher (40.6% ± 7.8) compared to the healthy controls (37.5% ± 6.9) (P=0.030), whereas hexagonality was significantly lower in patients with dry eye disease (51.5% ± 9.2) compared to the healthy controls (55.7% ± 9.6) (P=0.021). Pearson correlation analysis showed that there were statistically significant negative relationship between corneal ECD and dry eye severity parameters including the OSDI score (r= −0.32, P=0.020), corneal fluorescein staining (r= −0.29, P=0.01), and TBUT (r= −0.30, P=0.005).

Dry eye disease may cause a significant changes in corneal endothelial cell characteristics which correlates with clinical severity of the disease. Cases with pre-existing endothelial damage, such as those currently with low ECD or following intraocular procedures, should be evaluated for endothelial loss due to DED as well as DED.