Long-term Effects of Uncomplicated Traumatic Hyphema on Corneal and Lenticular Clarity

Abstract Purpose To examine whether uncomplicated traumatic hyphema affects endothelial morphology, anterior segment structure, and corneal/lenticular densitometry in the long term. Methods The study included 30 patients, with the study group formed of the eyes with a history of uncomplicated traumatic hyphema, and the control group of the healthy contralateral unaffected eyes. The corneal endothelial cell properties were captured via specular microscopy. Anterior segment analysis, corneal densitometry (12-mm corneal diameter), and lens densitometry measurements were taken using the Pentacam HR-Scheimpflug imaging system. Results Measurements were obtained at mean 49.5 ± 15.8 months after injury. The average endothelial cell density was significantly lower in the study group than in controls (2506.6 ± 294.0 vs. 2665.7 ± 195.0 cell/mm², p = 0. 020). There was no difference between the groups for polymegathism and pleomorphism ( p = 0. 061 and P = 0. 558, respectively). All investigated anterior segment parameters were similar in both groups ( p > 0. 05). The corneal densitometry values in all concentric zones and layers showed no difference between the groups ( p > 0. 05). The Lens Zone 1 densitometry value was significantly higher in the study group than in controls (9.6 ± 1.1 vs 8.9 ± 1.2, p = 0. 031). No difference was determined in respect of Zone 2 and 3 values ( p = 0. 170 and p = 0. 322, respectively). The degree of hyphema was not correlated with endothelial cell loss and change in Lens Zone 1 value (rho = 0.330, p = 0. 087; rho = 0.202, p = 0. 294, respectively). Conclusion Even if traumatic hyphema is not complicated, long-term outcomes indicate that traumatic hyphema may cause endothelial cell loss and increased lenticular density.