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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      Age-related changes in corneal thickness and endothelial characteristics

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          Abstract

          Purpose

          To determine the influence of age on central corneal thickness (CCT), endothelial cell density (ECD), average cell size, coefficient of variation in cell size, and percentage of regular hexagonal cells; and to estimate the average ECD and CCT in seven age groups.

          Materials and methods

          After obtaining informed consent, 211 Caucasian patients (358 eyes) were examined using a noncontact specular microscope at the Center of Eye Diseases in Vilnius University Hospital Santariskiu Clinic. The main corneal parameters were: ECD, average cell size, coefficient of variation in cell size, percentage of regular hexagonal cells, and CCT. Subjects (20–89 years) were stratified by age into seven groups. Correlations between CCT, endothelial parameters (ECD, percentage of regular hexagonal cells, average, coefficient of variation), and age were found. Student’s t-test and Pearson’s correlation coefficient ( r) values were calculated.

          Results

          A total of 114 (54.03%) women and 97 (45.97%) men participated in the study. Average ECD (cell/mm 2) ranged from 2,931 (±371) in 20–29 year olds to 2,222 (±182) in 80–89 year olds; CCT (μm) ranged from 563 (±44) in 20–29 year olds to 540 (±35) in 80–89 year olds. A strong inverse correlation was observed between age and corneal ECD ( r=−0.650, P<0.01) and a weak inverse correlation was observed between age and CCT ( r=−0.156, P<0.01). ECD and CCT correlated directly ( r=0.232, P<0.01). The average size of corneal endothelial cells directly correlated with age ( r=0.586, P<0.01). There was no correlation between age and the coefficient of variation in cell size nor the percentage of regular hexagonal cells ( P>0.05).

          Conclusion

          Young people have higher ECD. CCT also decreases, but its dependence on age is weaker. A lower cell density indicates a thinner cornea. The variation in cell size and percentage of regular hexagonal cells are not dependent on age.

          Most cited references37

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          Ten-year postoperative results of penetrating keratoplasty.

          To investigate the changes in central corneal endothelial cells and corneal thickness in transplanted corneas from 5 to 10 years after grafting. This study also aimed to investigate the development of glaucoma, graft rejection, and graft failure during the first 10 postoperative years. Longitudinal cohort study of 500 consecutive penetrating keratoplasties by 1 surgeon. Patients were asked to return for follow-up examinations at 2 months and at 1, 3, 5, and 10 years after grafting. The authors excluded eyes regrafted during the study and the fellow eyes of bilateral cases, leaving 394 grafts in 394 patients for analysis. Penetrating keratoplasty was performed. Using specular microscopy, the authors measured endothelial cell density, coefficient of variation of cell area, percentage of hexagonal cells, and corneal thickness. The authors performed clinical examinations to determine graft rejection or failure and the development of glaucoma. By 10 years postkeratoplasty, 80 of the 394 patients had died and 68 grafts had failed. Of the remaining 246 patients, 119 (48%) returned for their 10-year examinations. For the 72 patients who returned for all of the scheduled postoperative visits and had no rejection episodes, reoperations, or failure, endothelial cell loss from preoperative donor levels at 10 years was 67 +/- 18% (mean +/- standard deviation), endothelial cell density was 958 +/- 471 cells/mm2, coefficient of variation was 0.32 +/- 0.11, hexagonal cells were 56 +/- 12%, and corneal thickness was 0.58 +/- 0.05 mm. The 5- to 10-year changes for all these values were significant (P < or = 0.004). The mean rate of late endothelial cell loss from 5 to 10 years postkeratoplasty was 4.2% per year. Eyes that were aphakic after grafting had the lowest endothelial cell loss (57 +/- 24%) and the lowest interval cell loss from 5 to 10 years postkeratoplasty (4 +/- 19%). Eyes that were phakic had the highest endothelial cell loss (73 +/- 8%) and 5- to 10-year-interval cell loss (17 +/- 31%). Eyes with posterior chamber lenses had a greater endothelial cell loss (71 +/- 9%) than did eyes with anterior chamber lenses (51 +/- 25%, P = 0.03). The 10-year cumulative risk of glaucoma, rejection, or failure was 21%, 21%, and 22%, respectively. Late endothelial failure became the major cause for graft failure, accounting for 9 of the 11 failures after 5 postoperative years. From 5 to 10 years after penetrating keratoplasty, the annual rate of endothelial cell loss was seven times the normal rate. The endothelial cell loss, pleomorphism, polymegethism, and corneal thickness increased significantly during this time, indicating continued endothelial instability and dysfunction, resulting in an increasing rate of late endothelial failure.
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            Age-related differences in the normal human cornea: a laser scanning in vivo confocal microscopy study.

            To quantify and establish baseline normative data for age-related differences in cellular and innervation density in the normal, healthy, human cornea using laser scanning in vivo confocal microscopy.
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              Diurnal variations in human corneal thickness.

              To elucidate the diurnal variation in human corneal thickness over a 48 hour period. Changes in central corneal thickness were monitored in eight healthy subjects (four male, four female) aged between 10 and 63 years using an ultrasonic pachymeter. Measurements were made over a 48 hour period-immediately before sleep, immediately upon waking and at 15, 30, 45 minutes, 1, 1.5, 2, 2.5, 3 hours, and at 2 hour intervals thereafter throughout the remainder of each day. The mean corneal thickness for the group (SD) was 546 (14) microns, with a mean overnight increase of 5.5% (2.9%) (range 1.9-12.6%) and a maximum diurnal increase of 7.2% (2.8%) (range 2.1-14.3%). Individual differences in the extent of diurnal and overnight variation occurred within the group. For three subjects, the first reading taken on waking was not the highest and corneal thickness continued to increase. These data confirm an increase of corneal thickness during sleep, but also reveal considerable variation during waking hours. Thus, the overnight changes in corneal thickness are not truly representative of diurnal variations in human corneal thickness and, in fact, much greater diurnal variation occurs than the 3.0-4.4% previously reported.
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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                Clinical Interventions in Aging
                Dove Medical Press
                1176-9092
                1178-1998
                2013
                2013
                24 October 2013
                : 8
                : 1445-1450
                Affiliations
                Vilnius University Faculty of Medicine, ENT and Eye Diseases Clinic, Vilnius University Hospital Santariskiu Clinic, Center of Eye Diseases, Vilnius, Lithuania
                Author notes
                Correspondence: Saulius Galgauskas, Vilnius University Faculty of Medicine, Vilnius University Hospital Santariskiu Clinic, Center of Eye Diseases, Santariskiu 2, 08661, Vilnius, Lithuania, Tel +370 6872 6238, Email saulius.galgauskas@ 123456santa.lt
                Article
                cia-8-1445
                10.2147/CIA.S51693
                3810328
                24187493
                25a01d21-a55a-4b8a-bc70-e76abc446225
                © 2013 Galgauskas et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Health & Social care
                cornea,endothelium,age-related changes
                Health & Social care
                cornea, endothelium, age-related changes

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