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Effects of Smoking on Corneal Thickness
Candice Giordano, MD
February 25, 2011
Smoking and the Eye
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Cataracts
Thyroid eye disease
Macular degeneration
Polypoidal choroidal vasculopathy
Uveitis
Macular edema
Background
• Cigarette smoking is known to increase
systemic reactive oxygen species.
• It is not known if smoking decreases the
antioxidant properties of the aqueous humor.
– IL-6 has been shown to be elevated in the aqueous
of smokers.
• It is known if the aqueous is unhealthy, then
corneal thickness increases.
Background
• Corneal thickness has also been found to be a
predictor of glaucoma risk and can increase
after intraocular surgery and in unhealthy eyes
• Corneal guttata, which can be related to
corneal thickness, have been shown to be
associated with a 20 pack-year smoking
history.
Background
• A transcription factor known to bind the
antioxidant response element and activate
antioxidant defense, is down-regulated in
Fuchs’ endothelial corneal dystrophy
• Ex vivo, oxidative stress caused characteristic
morphological changes and apoptosis of
corneal endothelium
• Significantly higher levels of oxidative DNA
damage and apoptosis were detected in FECD
endothelium compared with normal controls.
Hypothesis
• It is hypothesized that a positve smoking
history will be associated with increased
corneal thickness. The objective of this study
is to determine if smoking is related to corneal
thickness as well as recovery from intraocular
surgery.
Methods
• Observational case series involving persons 18
years old or greater.
• The patients are being questioned regarding:
– their smoking history including duration of
smoking and number of packs per day
– history of ocular surgery
– history of antioxidant use
Methods
• Examination includes the following:
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visual acuity
intraocular pressure
corneal pachymetry
anterior and posterior eye exams if indicated for
that visit.
• Currently in data collection….
References
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Csiszar A, Podlutsky A, Wolin MS, Losonczy G, Pacher P, Ungvari Z. Oxidative stress and
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Hager A, loge K, Fullhas MO, Schroeder B, Grossherr M, Wiegand W. Changes in corneal
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Jurjunas UV, Bitar MS, Funaki T, Azizi B. Evidence of oxidative stress in the pathogenesis of fuchs
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Zoega GM, Fujisawa A, Sasaki H, et al. Prevalence and risk factors for corneal guttata in the
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