Correlation Between Corneal Endothelial Cell Changes And Ocular Biometric Parameters In An Apparently Healthy Adult Population – A Cross-Sectional Study

Corneal endothelial cells possess limited proliferative capacity, making their structural integrity vital for maintaining corneal transparency. This study investigated the relationship between corneal endothelial cell (CEC) indices—cell density (CD), coefficient of variation (CV), and hexagonality (HEX)—and ocular biometric parameters across different refractive states.

Tertiary care centre in South India

In this cross-sectional study, 68 participants (29 emmetropes, 29 myopes, and 10 hyperopes) underwent comprehensive ophthalmic evaluation. Endothelial parameters (CD, CV, HEX, and central corneal thickness [CCT]) were captured via specular microscopy, while ocular biometry—including axial length (AL), anterior chamber depth (ACD), white-to-white diameter (WTW), and corneal curvature (K)—was measured using the IOL Master. Statistical analyses included Pearson’s or Spearman’s correlations and independent t-tests or Mann-Whitney U tests for group comparisons.

A significant moderate positive correlation was observed between HEX and ACD ($\rho =0.356$, $p=0.005$), suggesting that deeper anterior chambers are associated with more regular cell morphology. As expected, AL and ACD were strongly correlated ($\rho =0.675$, $p<0.001$), and a robust negative correlation existed between CV and HEX ($\rho =-0.880$, $p<0.001$). While the myopic group exhibited significantly longer AL (25.16 mm vs. 23.26 mm, $p<0.001$) and deeper ACD (3.79 mm vs. 3.52 mm, $p<0.001$) than emmetropes, core endothelial health parameters (CD, CV, HEX) did not differ significantly between these refractive groups.

Ocular biometry, specifically anterior chamber depth, is linked to corneal endothelial morphology; eyes with deeper ACDs tend to maintain higher cell hexagonality. Despite the anatomical differences inherent in myopic eyes, their endothelial stability remains comparable to emmetropic eyes in this cohort, highlighting that axial elongation does not necessarily compromise endothelial health.