The endothelial cell damage in acute glaucoma. On the corneal thickness response to intraocular pressure

In order to assess a possible damage to the corneal endothelium during pressure induced abnormal hydration of the cornea, 23 patients with a previous attack of unilateral acute glaucoma were photographed with a specular microscope. As compared to the healthy side, the endothelium of the affected side showed a mean decrease in cell density of 23.1%, range --4.8 to 68% (P less than 0.001). In retrospect this cell loss was found to correlate significantly to the increase in corneal thickness measured during the acute attack on first day of admission. At present examination mean central corneal thickness was identical in the affected and unaffected eye. A large variation was, however, found in the intraocular pressure of the previously attacked eye. If the subject inter-eye difference in intraocular pressure was related to the inter-eye difference in corneal thickness is significant negative correlation appeared. It is concluded that the intraocular pressure has a dual effect on the corneal hydration: if the endothelium is intact, the intraocular pressure decreases corneal thickness, whereas an increase is seen only if the endothelium is acutely damaged.