Assessment of Anterior Segment Parameters and Specular Microscopy Findings in Patients with COPD

Objective: The aim of the present study was to assess the anterior segment parameters of patients with chronic obstructive pulmonary disease (COPD) by corneal specular microscopy and biometry and to compare the results with healthy controls. Materials and Methods: Our prospective study consisted of 122 eyes of 61 patients with COPD and 110 eyes of 55 patients without any systemic diseases. A comprehensive medical history was obtained, and corrected visual acuity, bio microscopic and fundus examination, intraocular pressure (IOP) measurement with applanation tonometry, and non-contact specular microscopy were performed in all participants. Results: The endothelial cell density was lower in the COPD group than in the control group (p<0.001). The coefficient of variation (CV) was higher, central corneal thickness was significantly higher, and hexagonal cell ratio (HEX) was lesser in the COPD group than in the control group (p<0.001). Any significant difference between the control and the COPD groups was not determined in comparison with IOP, mean axial length keratometry (Kmean), anterior chamber depth (ACD), and white-to-white limbus length (WTW) measurements. Patients were grouped into two regarding the disease severity as mild-moderate (group 1, n=20), and moderate-severe (group 2, n=41) according to the Global Initiative for Chronic Obstructive Lung Disease criteria. The number of endothelial cells was lesser, the CV was higher, and the HEX was lower in the moderate-severe COPD group than in the mild-moderate COPD group (p<0.001). The duration of smoking was significantly longer in the moderate-severe group than in the mild-moderate COPD group (p<0.001). Conclusion: We suggest that in patients with COPD, due to the reduction of endothelial functional preserve, the risk of corneal endothelial damage is increased in intraocular surgery. In patients with end-stage COPD, caution should be exercised with regard to endothelial decompensation, frequent disease in the general population, corneal parameters, and to define the alterations that the ocular surgeons should be cautious about. Data regarding the alterations in anterior segment parameters in patients with COPD are highly limited in the previous literature.