Risk factors for corneal endothelium dysfunction

Density of corneal endothelium is commonly used by clinician to evaluate the function of corneal endothelium.The importance of dysfunction of this layer has not been received enough attention in routine clinical works.Recently, dysfunction of corneal endothelium due to the ocular diseases and corneal transplantation has been updated.Different types of glaucoma cause different degrees of damage to the corneal endothelium.Among them, the most serious damage to the corneal endothelium is acute angle closure glaucoma.Different treatment patterns of glaucoma damage to endothelium also have different features.The occurrence frequency, severity of the inflammation and the course of uveitis are the important factors which affect the corneal endothelium.The pathologic changes of pseudoexfoliation syndrome includes hypoxic changes in the anterior chamber, deposition of extracellular matrix in anterior segment and fibroblastic changes of the endothelium.These pathologic changes can decrease the endothelium function and the tolerance of injury.For keratoplasty, corneal immunologic rejection, surgical options, the primary disease and secondary late endothelial failure are the important factors of corneal endothelium dysfunction.Diabetes is a common systemic disease that cause corneal endothelium reserve capacity reduced.The decreasing of Na⁺ /K⁺ -ATPase activity, the accumulation of advanced glycation end products, constant metabolic stress can reduce corneal endothelium wound-healing ability.Recent researches of risk factors for corneal endothelium dysfunction were summarized in this paper to help clinician understand and value assess this element before intraocular surgery.