Bullous keratopathy due to nonguttate corneal endothelial dystrophy

Corneal oedema and bullous keratopathy may occur following intraocular surgery or arise spontaneously in nonguttate eyes. In some patients the fellow eye shows a relatively normal endothelial cell count with abnormal pleomorphism and polymegathism of the endothelial cells, while in others it shows a markedly lowered endothelial cell count with no evidence of corneal guttae. A survey of 17 such patients suggested the following classification. 1. Nonguttate corneal endothelial dystrophy with irregular endothelial cell morphology but a relatively normal endothelial cell count occurring following surgery (eight patients) or spontaneously (four patients). 2. Nonguttate corneal endothelial dystrophy with grossly reduced endothelial cell count occurring spontaneously (two patients). Three additional post-surgical patients showed a relatively normal endothelial cell count and only mild changes in the morphology of the corneal endothelium. These findings support the presence of a nonguttate corneal endothelial dystrophy in both the spontaneous and some of the post-surgical cases.