Diminished%20Endothelial%20Cell%20Counts%20in%20Corneas%20with%20Krukenberg%20Spindles

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Diminished Endothelial Cell Counts in Corneas
with Krukenberg Spindles

• Authors Tod M. Haller1, Chad B. Haller2, Melvin
  L. Haller1, Judah Beck3, Keith Haller4

1 Ophthalmology, Bronx-Lebanon Hospital Center,
Bronx, NY 2 Ophthalmology, Albert Einstein
College of Medicine, Bronx, NY 3 Howard
University School of medicine 4 New York College
of Osteopathic Medicine
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Purpose

• To determine if the presence of Krukenberg
  spindles affect the corneal endothelial cell
  count.

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Methods

• A retrospective study was performed on 41
  patients (80 eyes), who presented with Krukenberg
  spindles and had corneal endothelial cell counts
  performed at the time of initial presentation.
  The Konan SP-4000US Specular Microscope was used
  to photograph and calculate the endothelial cell
  density of each eye. Eyes that had elevated
  intraocular pressure (gt 21mm Hg 1 eye) or had
  previously undergone intraocular surgery (1 eye)
  were excluded from the study. Patients were
  categorized into groups based on age. The mean
  endothelial cell count of each age group was then
  compared to data previously published for
  age-matched controls.

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Results

• Corneas with Krukenberg spindles exhibited
  significantly lower corneal endothelial cell
  counts as compared to the normal range of
  aged-match controls. The percent reduction in
  endothelial cell count of each age group was as
  follows 30-39 year group 45 40-49 year group
  44 50-59 year group 42 60-69 year age group
  44 70-79 year age group 38 80-89 year age
  group 45.

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Endothelial Cells
Age range
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Results
BJO Normal Ranges
means of our group 30s 2800-4200 (mean
3500) 1891 40s 3200-4100 (mean
3650) 2033.07 50s 2800-3800 (mean
3300) 1924.14 60s 2700-3700 (mean
3200) 1792.7 70s 2800-3600 (mean
3200) 1995.17 80s 2900-3600 (mean
3250) 1802.25
reduction our group MEAN
loss 30s 33.5-55 45.07 40s
36.5-50.4 43.89 50s 31.3-49.4 41.69 60s
33.6-51.5 43.98 70s 28.7-44.6 37.65 80
s 37.9-49.9 44.55
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Conclusion

• Corneas with Krukenberg spindles were found to
  have significantly lower endothelial cell counts
  as compared to normal ranges of age-matched
  controls. The ophthalmic surgeon may want to
  consider specular microscopy prior to performing
  intraocular surgeries in eyes exhibiting
  Krukenberg spindles.

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References

• Effect of age on the endothelial cell count in
  the normal eye. R S Wilson and M J Roper-Hall.
  British Journal of Ophthalmology. 1982 August
  66(8) 513515.
• Photo on Slide 4 taken by Pearl Rosenbaum, MD