M Pajaujis

Central corneal thickness and corneal endothelial characteristics in healthy, cataract, and glaucoma patients

Purpose The aim of this study was to describe and compare endothelial cell parameters and central corneal thickness (CCT) in four different groups of patients (patients with cataract, patients with glaucoma, elderly healthy subjects, and young healthy subjects) and identify correlations between these characteristics, patient age, and sex. Methods Before conducting invasive procedures, 104 patients were examined using a non-contact specular microscope. Parameters examined included endothelial cell density (ECD), percentage of regular hexagonal cells (6A), average size of endothelial cells (Ave), and CCT. Patients’ ages and sexes were also noted. Results A total of 47 (45%) patients were men and 57 (55%) were women. CCT, ECD, 6A, and Ave in cataract group were 540 (±64) μm, 2633 (±430) cells/mm2, 60 (±10)%, and 390 (±66) μm, respectively; these values in the glaucoma group were 553 (±32) μm, 2484 (±82) cells/mm2, 60 (±10)%, and 397 (±58) μm. In the elderly group these figures were 545 (± 39) μm, 2394 (±416) cells/mm2, 64 (±10)%, and 386 (±43) μm; and in young healthy subjects the values were 555 (±43) μm, 2940 (±345) cells/mm2, 66 (±10)%, and 345 (±42) μm. A weak inverse correlation was observed between ECD and subject age (r = −0.459; P < 0.05) and between ECD and CCT (r = 0.232; P < 0.05). CCT was inversely correlated with patient age (r = −0.13; P = 0.189), but statistically significant data was observed only for the glaucoma group (r = −0.572; P < 0.05). Conclusion ECD in young subjects was higher than in elderly subjects in all groups; these patients have more endothelial cells and smaller, thicker corneas. The corneal endothelium cells in males have more regular hexagonal cells than do females. No difference in CCT and the ECD was observed between sexes. CCT and average size of endothelial cells do not differ between groups.

Ocular surface reconstruction using amniotic membrane following excision of conjunctival and limbal tumors.

Purpose To report the clinical results of patients treated by preserved human amniotic membrane transplantation (AMT) following the removal of conjunctival and limbal tumors. Methods Retrospective noncomparative interventional case series of 9 patients (9 eyes) who underwent AMT after removal of conjunctival and limbal tumors with lesion-free margins and perilesional cryotherapy. Results The excised tumors were histopathologically examined and included 2 squamous cell carcinomas, 2 papillomas, and 5 nevi. Bulbar conjunctiva was involved in all of the eyes, limbus and cornea in 7 and 3 eyes, respectively. The mean extent of the limbal involvement was 4 clock hours (range 2–9, SD 2.4); the average diameter of the base of the tumor was 12.8 mm (range 10–20, SD 4.4). The mean follow-up time was 38 months (range 13–60, SD 15). No surgical or early postoperative complications were observed. In all eyes, complete healing of the tissue defect occurred, resulting in a stable, wet, and noninflamed epithelium. All eyes demonstrated a smooth ocular surface except one with a clinically insignificant Symblepharon after the excision of a squamous cell carcinoma. Superficial peripheral corneal vascularization and opacification as a sign of partial limbal stem cell deficiency developed in 2 eyes. In one case, a recurrence of conjunctival papilloma was diagnosed after a 3-year follow-up. Conclusions Amniotic membrane transplantation is an effective method of reconstruction following a conjunctival and limbal tumor excision and cryotherapy of surgical wound margins. In most cases, complete healing of an ocular surface can be achieved without any clinically significant complications.