Abstract
To investigate the effects of pterygium on corneal endothelial cell density in patients with unilateral pterygium. We performed a cross-sectional analysis of data from patients with unilateral pterygium who were selected from September 1, 2015 to July 31, 2016 at Hospital de Base do Distrito Federal to assess the corneal endothelial cell density, coefficient of variation in the cell area, hexagonality, and corneal pa-chymetric results. In all patients, noncontact specular microscopy was performed in both eyes and a minimum endothelial cell count of 75 cells/mm2 was required for inclusion in the study. The contralateral eye served as the control. Sixty-one patients were included in the study. Twenty-nine (47.5%) patients were men and 32 (52.5%) were women (mean age, 50.84 ± 13.8). The percentage of pterygium that invaded the cornea ranged from 4.87% to 24.59% (median, 9.70% ± 4.99%). The mean corneal endothelial cell density (cells/mm) was lower in the pterygium eyes than in the controls (2451.83 ± 284.96 vs. 2549.95 ± 268.94, respectively; p=0.04). No differences in the mean coefficients of variation of cell size, hexagonality, and corneal pachymetric results were observed between the patients and controls. The Pearson correlation test showed a significant negative linear relationship between pterygium invasion and endothelial cell density [p<0.001, n=61, r=-0.553 (95% CI, -0.34 to -0.73)]. Compared with the contralateral eyes, those of patients with unilateral pterygium were associated with a decrease in corneal endothelial cell density.
Highlights
Pterygium is a wing-shaped ocular surface lesion described as an invasion of the bulbar conjunctiva onto the cornea[1]
Teste de correlação de Pearson mostrou uma relação linear negativa entre a invasão do pterígio e a densidade de células endoteliais corneanas [p
From the histopathological point of view, pterygium is a hyperplastic, centripetally directed growth of modified limbal epithelial cells accompanied by BL dissolution, epithelial mesenchymal transition, and activation of fibroblastic stroma associated with inflammation, neovascularization, and matrix remodeling, all of which are mediated through the combined actions of cytokines, growth factors, and matrix metalloproteinases[1,2]
Summary
Pterygium is a wing-shaped ocular surface lesion described as an invasion of the bulbar conjunctiva onto the cornea[1]. The expression of proteases, such as matrix metalloproteinases (MMPs), that degrade basement membrane and BL have been found to be elevated in the leading edges of pterygia[5]. These proteases released by pterygium cells facilitate invasion by degrading basement membrane components, and dissolving BL and adjacent stromal matrix[5,6]
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