Pterygium Is Related to a Decrease in Corneal Endothelial Cell Density

Hsu, Min‐Yen; Lee, Hsin-Nung; Liang, Chiao-Ying; Wei, Li-Chen; Wang, Chun-Yuan; Lin, Keng‐Hung; Shen, Ying-Cheng

doi:10.1097/ico.0000000000000149

Cited by 16 publications

(35 citation statements)

References 18 publications

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“…However, the results of our study came to a different conclusion. The ECD decrease in eyes with pterygium from our retrospective study was far less (76 cells/mm 2 , 3.1%) than those in the previous studies [11, 13, 15]. In our retrospective study, the ECD of eyes with unilateral pterygium was almost the same as the ECD of the contralateral eyes.…”

Section: Discussioncontrasting

confidence: 57%

“…Theoretically, these mediators and ultraviolet light may also damage corneal endothelium cells (ECC) and corneal endothelial cell density (ECD) may be decreased in eyes with pterygium [10]. Although results from previous clinical studies were consistent with this theory [11–13], in our cataract clinic we found that the preoperative ECD was not significantly decreased in cataract eyes with primary pterygium compared to those without pterygium. We speculated that pterygium might not be associated with ECD decrease in our population.…”

Section: Introductionmentioning

confidence: 54%

“…Pterygium may cause corneal surface irregularity and astigmatism [5–6]. Previous studies had shown that pterygium might also be associated with deeper corneal changes [11–13]. Mootha et al first described changes at the corneal endothelium and the Descemet membrane underlying or directly adjacent to the pterygium [13].…”

Section: Discussionmentioning

confidence: 99%

“…In their study the mean ECD decrease was 367 cells/mm 2 in eyes with unilateral pterygium [13]. Hsu et al also detected an ECD decrease of 230 cells/mm 2 (9.75%) in eyes with unilateral pterygium compared to the contralateral eyes [11]. They showed that 48.9% of the patients with unilateral pterygium had significant ECD decrease in the affected eyes, and the extent of ECD decrease was correlated with the size of the pterygium [11].…”

Section: Discussionmentioning

confidence: 99%

“…All of the eyes underwent routine preoperative examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior segment examination by slit-lamp, A-scan and B-scan ultrasonography (in the retrospective study). ECD was measured by the same technician using a specular microscope (SP-3000P; Topcon) and the center-to-center method [11]. ECD was measured one time for each eye with a cell count of at least 60 cells in the retrospective study and was measured three times consecutively for each eye with the cell counts of at least 80 cells in the prospective study.…”

Section: Methodsmentioning

confidence: 99%

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Primary pterygium was not associated with corneal endothelial cell decrease in a rural Chinese population

et al. 2019

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21 Purpose: To investigate the corneal endothelial cell density (ECD) in eyes 22 with primary pterygium.23 Methods: We first conducted a retrospective study to compare the ECD 24 between 1670 eyes with primary pterygium and 4060 eyes without pterygium. 25 Then we designed a prospective study to confirm the critical findings of the 26 retrospective study in 95 patients with unilateral primary pterygium.27 Results: In the retrospective study, the mean preoperative ECD in eyes with 28 primary ptergyium (2453±306 cells/mm 2 ) was statistically significantly lower 29 than those in eyes without pterygium (2529±313 cells/mm 2 , P<0.0001). 30 However, the difference was minor (76 cells/mm 2 , 3.1%). In the prospective 31 study, the mean ECD in eyes with unilateral primary pterygium (2480±263 32 cells/mm 2 ) was not significantly different from those in the contralateral eyes 33 (2527±277 cells/mm 2 , P=0.20). The hexagonality (P=0.10) or coefficient of 34 variation of size (P=0.15) of corneal endothelial cells was not significantly 35 different between eyes with pterygium and the contralateral eyes.36 Conclusion: Primary pterygium may not be associated with ECD decrease 37 in our study cohort. 38 Keywords: pterygium; corneal endothelial cell density; repeatability; 39 ultraviolet radiation 7 120 between patients in the PT group and those in the NPT group, or among 121 patients with bilateral pterygium, unilateral pterygium or without pterygium 122 (P>0.05). 123 The mean age of the patients (40 males and 55 females) in the 124 prospective study was 63.7±8.8 years. Forty-nine patients had pterygium in 125 the right eyes and 45 patients had pterygium in the left eye.126 ECD in the retrospective study 127 The mean preoperative ECD in the PT group (2453±306 cells/mm 2 ) 128 was statistically significantly lower than those in the NPT group (2529±313 129 cells/mm 2 , P<0.0001). The difference in ECD between the PT group and the 130 NPT group was 76 cells/mm 2 (3.1%). There was statistically significant 131 difference in preoperative ECD among patients with bilateral pterygium 132 (2444±329 cells/mm 2 ), unilateral pterygium (2486±309 cells/mm 2 ) or without 133 pterygium (2535±303 cells/mm 2 , P=0.001). In subgroup analysis, patients 134 with bilateral pterygium had lower ECD than patients without pterygium (91 135 cells/mm 2 , 3.7%, P=0.01). However, in patients with unilateral pterygium, the 136 ECD of the pterygium eyes (2487±313 cells/mm 2 ) was very similar to the 137 ECD of the contralateral eyes (2486±306 cells/mm 2 , P=0.99). The similar 138 ECD in both eyes of patients with unilateral pterygium raised our suspect 139 that ECD might not be decreased in eyes with pterygium in our population. 157 158 Discussion 9 159Pterygium is commonly seen in areas within the "pterygium zone" and 160 in people with outdoor occupations [1][2][3][4]. In our retrospective study, 29.1% 161(1670/5730) of eyes underwent cataract surgery had concomitant pterygium. 162Pterygium may cause corneal surface irregularity and astigmatism [5][6]....

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Section: Discussioncontrasting

confidence: 57%

Section: Introductionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Primary pterygium was not associated with corneal endothelial cell decrease in a rural Chinese population

et al. 2019

Preprint

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Essential role of ultraviolet radiation in the decrease of corneal endothelial cell density caused by pterygium

Dai

et al. 2018

Eye

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Pterygium Is Related to Short Axial Length

Zhang

Yang

Gong

2019

Cornea

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Purpose: To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length. Methods: A retrospective, hospital-based cross-sectional study included 521 eyes from 521 patients who were enrolled through a community survey by Shanghai Heping Eye Hospital was conducted. Patients with primary pterygium in at least 1 eye were considered the pterygium group, and those with normal eyes were considered the nonpterygium group. The prevalence and length of pterygium, refractive characteristics including spherical power, astigmatism, corneal curvature, and anatomical parameters including axial length, anterior chamber depth, endothelial cell density, and corneal thickness were compared between groups. Results: Five hundred twenty-one eyes of 521 patients (214 men and 307 women) with a mean age of 70.5 ± 7.6 years were included in the study. The prevalence of hyperopia (81.6%, 65.1%, P = 0.001), axial length (23.1 ± 1.2 mm, 24.2 ± 2.4 mm, P < 0.001), anterior chamber depth (2.9 ± 0.3 cm, 3.1 ± 0.4 cm, P = 0.001), flat K value (42.94 ± 2.16 diopters, 43.73 ± 1.48 diopters, P = 0.002), Kmax (51.13 ± 7.74 diopters, 47.49 ± 5.62 diopters, P < 0.001), and spherical power (0.97 ± 2.40 diopters, −0.82 ± 4.40 diopters, P < 0.001) were statistically different between the pterygium and nonpterygium groups. Age (r = −0.21, P = 0.025), corneal astigmatism (r = −0.41, P < 0.001), flat K value (r = −0.39, P < 0.001), and endothelial cell density (r = −0.33, P = 0.001) were all negatively correlated with the length of pterygium. The prevalence of pterygium and severe pterygium over 3 mm were statistically different according to the severity of hyperopia (P < 0.001) and axial length (P < 0.001). Stratified χ2 analysis showed that axial length, rather than hyperopia, was a related factor to pterygium (odds ratio = 5.23, 95% confidence interval: 2.50–10.93). Conclusions: We conclude from our study that the prevalence of pterygium is related to small eye size. SDF-1/CXCR4 signaling may play a vital role in pterygium and shorter axial length. Further study focused on SDF-1/CXCR4 signaling will be needed.

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Pterygium Is Related to a Decrease in Corneal Endothelial Cell Density

Abstract: Pterygium is related to a decrease in corneal ECD. Surgical intervention should be considered in patients with extensive pterygium involvement in the cornea or a significant increase in astigmatism.

Cited by 16 publications

References 18 publications

Primary pterygium was not associated with corneal endothelial cell decrease in a rural Chinese population

Primary pterygium was not associated with corneal endothelial cell decrease in a rural Chinese population

Essential role of ultraviolet radiation in the decrease of corneal endothelial cell density caused by pterygium

Pterygium Is Related to Short Axial Length

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