Corneal Endothelial Changes in Patients with Traumatic Hyphema

ABSTRACT

PURPOSE: In patients with traumatic hyphema, we investigated the changes of corneal endothelium and the associated ocular complications that might attribute to endothelial damage. MATERIALS & METHODS: We reviewed the medical records of 67 patients(67 eyes) who had been admitted and treated for blunt ocular trauma with hyphema between February 1997 and June 2000. One month after injury, endothelial photographs of both eyes of each patient were taken with specular microscope to compare the endothelium of the injured eyes with that of the normal fellow eyes. The endothelial parameters were studied in relationship to various complications to see the relationship between the complications and the endothelial damage. RESULTS: Compared with the fellow uninjured eyes, the injured eyes had a mean decrease in endothelial cell density (ECD) of 5.6% (P=0.015). Nine patients had significant corneal edema with epithelial defect on initial admission, which was defined as corneal impact lesion. In the group with the corneal impact lesion, the mean ECD decrease was 23.1% (P=0.016) and the mean coefficient of variation (COV) increase was 24.8% (P=0.01). With other variables such as the amount of hyphema and the degree of angle recession, statistically significant results could not be obtained. In 20 patients on long-term follow-up examination (mean 36.7 months after the injury), the injured eyes had a mean increase in ECD of 2.5% compared to the result on initial examination. This change was minimal and statistically not significant. CONCLUSION: In patients with traumatic hyphema, this study showed reduced endothelial cell densities in the injured eyes compared to the normal fellow eyes. In particular, statistically significant decrease in ECD was noted to be associated with corneal impact lesion.