Correlations of Corneal Endothelial Morphology and Corneal Thickness With Anterior Segment Parameters in Healthy Individuals

Abstract

Purpose: The purpose of this study was to investigate the associations between central corneal endothelial cell density (ECD), endothelial morphology, and corneal thickness (central corneal thickness) with the anterior chamber depth, corneal volume (CV), white-to-white (WTW) distance, mean anterior chamber angle (CAmean), and gender in healthy individuals. Methods: This observational study included 136 healthy volunteers. The ECD, coefficient of variation of cell area, and hexagonal cell appearance ratio (%Hex) were measured by means of specular microscopy. The central corneal thickness, anterior chamber depth, CV, WTW distance, and the angle width of 12 points were taken by the Pentacam HR Scheimpflug anterior segment imaging. The arithmetical mean of the 12 points was considered as the CAmean. We used mixed effect linear regression model for the statistical analysis of the data. Results: ECD was positively correlated with CV (P = 0.028), while after adjusting for age, it was negatively correlated with age (P < 0.001). Coefficient of variation of cell area was positively correlated with CAmean (P = 0.036), while after adjusting for age, it was positively correlated with age (P < 0.001) and CAmean (P = 0.005). Hex was negatively correlated with WTW (P = 0.023) and CAmean (P = 0.025), and after adjusting for age, this correlation remained the same (P = 0.029 when correlated with WTW and P = 0.035 with CAmean). Conclusions: There were significant changes in the morphology of the corneal endothelial cells in eyes with wider anterior chamber angle. Greater pleomorphism and polymegethism of the corneal endothelium was observed in healthy patients with wider CAmean. Deepening of the anterior chamber as myopia progresses could render the corneal endothelium more fragile and susceptible to mechanical stress, which is an area worthy of further study.