1. 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

2. Purpose: To determine if the presence of Krukenberg spindles affect the corneal endothelial cell count. To determine if the presence of Krukenberg spindles affect the corneal endothelial cell count.

3. 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 (> 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. 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 (> 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.

5. 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%. 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%.

6. Endothelial Cells Age range

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

8. 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. 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.

9. 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): 513–515. “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): 513–515. Photo on Slide 4 taken by Pearl Rosenbaum, MD Photo on Slide 4 taken by Pearl Rosenbaum, MD