[Morphometric and qualitative changes in corneal endothelium in pseudoexfoliation syndrome]

In a prospective study begun in March 1986, in 182 eyes with pseudoexfoliation syndrome (PES) specular microscopic endothelial cell photographs were taken with direct and non-direct specular microscopy in non-selected patients who had not undergone intraocular surgery. Age-matched cataract eyes with normal intraocular pressure served as a control group. Standard specular microscopic examination (Bio Optics LSM 2000 A and Clinical Specular Microscope Camera) to evaluate the endothelial cell count and the morphology and quality of the endothelium yielded the following results. In 4432 control eyes with normal intraocular pressure the cell count was observed to be age-dependent and to have an average value of 2302 +/- 394 cells/mm2, the cells generally had a regular arrangement. In 123 eyes with pseudoexfoliation syndrome there was a significant (p less than 0.001) reduction in cell count to 1812 +/- 297 cells/mm2. In 59 eyes with PES and manifest glaucoma there was a significant (p less than 0.001) reduction of the corneal endothelium to 1482 +/- 267 cells/mm2. The cell picture was composed of enlarged, regularly arranged cells. In addition, such endothelial changes as incomplete cell lesions, cell detritus and appositions were six times as frequent as in normal eyes. In 32% of the eyes affected by PES we found manifest glaucoma. The statistical evaluation (matched age groups ect.) was carried out by means of the Mann-Withney-Wilcoxon rank test.