Effect of Intravitreal Injection of Methotrexate on Human Corneal Endothelial Cells.
PURPOSE
To evaluate the toxic effect of intravitreal methotrexate on human corneal endothelium.


METHODS
In this prospective noncomparative interventional case series, intravitreal injection of 400 μg methotrexate was performed in eyes with persistent diabetic macular edema. Corneal endothelial cell analyses and central corneal thickness measurements were performed before and 1, 3, and 6 months after injections, using noncontact specular microscopy.


RESULTS
Twenty one eyes of 18 patients with a mean age of 60.5 ± 6.8 years were evaluated. No statistically significant difference was found in endothelial cell density, coefficient of variation, average cell area, hexagonality, and central corneal thickness measurements before and after injections (P = 0.70, 0.39, 0.43, 0.64, and 0.67, respectively).


CONCLUSIONS
In this 6-month follow-up study, intravitreal injection of 400 μg methotrexate had no significant effect on corneal endothelial cell measurements performed by specular microscopy.