title: Corneal endothelial changes in patients with chronic obstructive pulmonary disease and corneal vulnerability to cataract surgery.
abstract: OBJECTIVE
  To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for a reduced corneal endothelium functional reserve after cataract surgery.
  
  
  METHODS
  Department of Ophthalmology, Hospital Universitari Sant Joan, Reus, Spain.
  
  
  METHODS
  Prospective clinical observational cohort study.
  
  
  METHODS
  Patients were assigned to 1 of the following 3 groups: mild-to-moderate COPD, severe-to-very severe COPD, and without COPD (control). Before and 3 months after phacoemulsification, specular microscopy was used to evaluate the number and morphology of endothelial cells and the central corneal thickness (CCT) was measured to evaluate corneal decompensation.
  
  
  RESULTS
  Preoperative results were recorded for 165 eyes. The mild-to-moderate COPD group comprised 67 eyes; the severe-to-very severe COPD group, 40 eyes; and the control group, 58 eyes. Cataract surgery was performed in 112 eyes. Significant differences in nearly all preoperative and 3-month postoperative corneal endothelial parameters were observed between the COPD groups and the control group, the former having a lower cell density and percentage of hexagonal cells and a higher coefficient of variance of the mean cell area. Two weeks postoperatively, the percentage of mild central corneal edema was 0%, 36%, and 31% in the control group, mild-to-moderate COPD group, and severe-to-very severe COPD group, respectively. There was no significant difference in the preoperative or 3-month postoperative mean CCT between the groups.
  
  
  CONCLUSIONS
  Chronic obstructive pulmonary disease reduced endothelial functional reserve and increased corneal endothelial vulnerability to intraocular surgical stress.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain. Electronic address: nsolerl@gmail.com.
authors: Núria
authors: N
authors: Soler
authors: From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain.
authors: Pere
authors: P
authors: Romero-Aroca
authors: From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain.
authors: Oscar
authors: O
authors: Gris
authors: From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain.
authors: Jordi
authors: J
authors: Camps
authors: From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain.
authors: Joan
authors: J
authors: Fernandez-Ballart
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D015331:Cohort Studies; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis / Q000503:physiopathology*; D063171:Corneal Pachymetry; D019781:Corneal Topography; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000503:physiopathology*; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology