Adem UĞURLU, Mukadder SUNAR, Yücel KARAKURT, Sumeyye Burcu AGCAYAZI, Erel İÇEL, Nurdan Gamze TASLI, Turgay UÇAK

Evaluation of the effect of chronic smoking habit on corneal endothelial cells, central corneal thickness and dry eye tests

Aim: The aim of our study was to evaluate the effects of chronic smoking habit on corneal endothelial cells, central corneal thickness,and dry eye tests.Material and Methods: A total of 160 eyes of 160 chronic smokers and 160 eyes of 160 control cases were included in the study. Thesmokers were grouped into 4 groups according to pack-year smoking as follows: 0-10, 10-20, 20-30, >30. Endothelial cell density(CD), average cell size (AVG), percentage of hexagonal cell (HEX), and coefficient of variation (CV), central corneal thickness (CCT)were measured using a specular microscope. The Tear Break-Up Time (TUBT) and Schirmer tests were performed.Results: In Group 1 and Group 2, there was no significant difference between the smoker and the control groups in terms of CD, AVG,HEX and CV. In Group 3 and Group 4, there was a significant decrease in CD and HEX values, while there was a significant increasein AVG and CV values. CCT values were not significantly different in the Groups 1,2 and 3, whereas there was a significant decreasein the Group 4. TBUT and Schirmer tests were significantly decreased in all groups.Conclusion: It was found that as the number of pack-year increased, CD and HEX values decreased and AVG and CV values increased.Dry eye tests were affected in a shorter period of time, while CCT was affected in a longer period of time than the time required forCD, HEX, AVG and CV parameters to be affected.

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1. World Health Organization, & Research for International Tobacco Control. WHO report on the global tobacco epidemic, 2008: The MPOWER package. World Health Organization.
2. Chiba M, Masironi R. Toxic and trace elements in tobacco and tobacco smoke. Bulletin of the World Health Organization 1992;70:269-75.
3. Solberg Y, Rosner M, Belkin M. The association between cigarette smoking and ocular dis-eases. Survey Ophthalmol 1998;42:535-47.
4. Yanbaeva DG, Dentener MA, Creutzberg EC, et al. Systemic effects of smoking. Chest 2007;131:1557-66.
5. Jensen JA, Goodson WH, Hopf HW, et al. Cigarette smoking decreases tissue oxygen. Arch surg 1991;126:1131-4.
6. Fletcher AE. Free radicals, antioxidants and eye diseases: evidence from epidemiological studies on cataract and agerelated macular degeneration. Ophthalmic Res 2010;44:191-8.
7. Fernandez-Robredo P, Moya D, Rodriguez JA, et al. Vitamins C and E reduce retinal oxida-tive stres and nitric oxide metabolites and prevent ultrastructural alterations in porcine hyper-cholesterolemia. Invest Ophthalmol Vis Sci 2005;46:1140-6.
8. Bartecchi CE, MacKenzie TD, Schrier RW. The human costs of tobacco use. N Engl J Med 1994;330:907-12.
9. Milara J, Cortijo J. Tobacco, inflammation, and respiratory tract cancer. Curr Pharm Des 2012;18:3901-38.
10. Handa S, Woo JH, Wagle AM, et al. Awareness of blindness and other smoking-related dis-eases and its impact on motivation for smoking cessation in eye patients. Eye (Lond) 2011;25:117-6.
11. Edwards R, Thornton J, Ajit R, et al. Cigarette smoking and primary open angle glaucoma: a systematic review. J Glaucoma 2008;17:558-66.
12. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Oph-thalmol 2000;118:1264-8.
13. The Eye Disease Case-Control Study Group. Risk factor for neovascular age-related macular degeneration. Arch Ophthalmol 1992;110:1701-8.
14. Christen WG, Manson JE, Seddon JM, et al. A prospective study of cigarette smoking and risk of cataract in men. J Am Med Assoc 1992;268:989-93.
15. Prummel MF, Wiersinga WM. Smoking and risk of Graves’ disease. J Am Med Assoc 1993;269:479-82.
16. Thorne JE, Daniel E, Jabs DA, et al. Smoking as a risk factor for cystoid macular edema com-plicating intermediate uveitis. Am J Ophthalmol 2008;145:841-6.
17. Velilla S, Garcia-Medina JJ, Garcia-Layana A, et al. Smoking and agerelated macular degen-eration: review and update. J Ophthalmol 2013;2013:895147.
18. Rummenie VT, Matsumoto Y, Dogru M, et al. Tear cytokine and ocular surface alterations following brief passive cigarette smoke exposure. Cytokine 2008;43:200-8.
19. Ozcura F, Oruc SD, Meteoglu I, et al. Effects of long-term passive smoking on vascular endo-thelial growth factor and apoptosis markers expression in lens and corneal epithelial cells: an experimental study. Turk J Med Sci 2009;39:843-8.
20. Satici A, Bitiren M, Ozardali I, et al. The effects of chronic smoking on the ocular surface and tear characteristics: a clinical, histological and biochemical study. Acta Ophthalmol Scand 2003;81:583-7.
21. Joyce NC. Proliferative capacity of corneal endothelial cells. Experimental eye research. 2012;95:16-23.
22. Ishikawa A. Risk factors for reduced corneal endothelial cell density before cataract surgery. J Cataract Refract Surg 2002;28:1982-92.
23. Leung BK, Bonanno JA, Radke CJ. Oxygen-deficient metabolism and corneal edema. Prog Retin Eye Res 2011;30:471-92.
24. Johns KJ, Feder RS, Hamil MB, et al. Telescopes and optical instruments. The foundation of American Academy of Ophthalmology. Basic and clinical science course. Section 3 Optics Refraction and Contact Lenses. San Francisco: The foundation of AAO 2007;9:241-89.
25. Bourne RRA, Minassian DC, Dart JKG, et al. Effect of cataract surgery on the corneal endo-thelium. Modern phacoemulsification compared to extracapsular cataract surgery. Ophthalmol 2004;111:679-85.
26. Langhans M, Michelson G, Groh MJ. Effect of breathing 100% oxygen on retinal and optic nerve head capillary blood flow in smokers and non-smokers. Br J ophthalmol 1997;81:365-9.
27. Kara S, Gencer B, Türkön H, et al. The Effect of Smoking on Corneal Endothelial Cells. Sem-inars ophthalmol 2017;32:223-7.
28. Ilhan N, Ilhan O, Coskun M, et al. Effects of smoking on central corneal thickness and the corneal endothelial cell layer in otherwise healthy subjects. Eye Contact Lens 2016;42:303-7.
29. Vayssier-Taussat M, Camilli T, Aron Y, et al. Effects of tobacco smoke and benzo[a]pyrene on human endothelial cell and monocyte stress responses. Am J Physiol Heart Circ Physiol 2001;280:293-300.
30. Raitio A, Tuomas H, Kokkonen N, et al. Levels of matrix metalloproteinase-2, -9 and -8 in the skin, serum and saliva of smokers and non-smokers. Arch Dermatol Res 2005;297:242-8.
31. Sayin N, Kara N, Pekel G, et al. Effects of chronic smoking on central corneal thickness, endothelial cell, and dry eye parameters. Cutan Ocular Toxicol 2014;33:201-5.
32. Golabchi K, Abtahi MA, Salehi A, et al. The effects of smoking on corneal endothelial cells: a cross-sectional study on a population from Isfahan, Iran. Cutaneous and ocular toxicology 2018;37:9-14.
33. Sopapornamorn N, Lekskul M, Panichkul S. Corneal endothelial cell density and morphology in Phramongkutklao Hospital. Clin Ophthalmol 2008;2:147-51.
34. Zoega GM, Fujisawa A, Sasaki H, et al. Prevalence and risk factors for cornea guttata in the Reykjavik Eye Study. Ophthalmol 2006;113:565-9.
35. Altinors DD, Akca S, Akova YA, et al. Smoking associated with damage to the lipid layer of the ocular surface. Am J Ophthalmol 2006;141:1016-21.
36. Yoon KC, Song BY, Seo MS. Effects of smoking on tear film and ocular surface. Korean J Ophthalmol 2005;19:18-22.
37. Grus FH, Sabuncuo P, Augustin A, Pfeiffer N. Effect of smoking on tear proteins. Graefes Arch Clin Exp Ophthalmol 2002;240:889-92.
38. Thomas J, Jacob GP, Abraham L, et al. The effect of smoking on the ocular surface and the precorneal tear film. Australas Med J 2012;5:221-6.
39. Wang D, Huang Y, Huang C, et al. Association analysis of cigarette smoking with onset of primary open-angle glaucoma and glaucoma-related biometric parameters. BMC Ophthalmol 2012;12:59.
40. Knuutinen A, Kokkonen N, Risteli J, et al. Smoking affects collagen synthesis and extracellu-lar matrix turnover in human skin. Br J Dermatol 2002;146:588-94.