Corneal Endothelial Changes in Pseudoexfoliation Syndrome

Using specular microscopy and computer-assisted morphometry, we studied 27 eyes with Pseudoexfoliation syndrome, 17 apparently normal fellow eyes, and 15 eyes of matched normal subjects with no ocular disease other than senile cataract. Endothelium of the eyes with Pseudoexfoliation syndrome showed significantly lower cell density than did the endothelium from control eyes. Endothelium of both eyes of patients with unilateral Pseudoexfoliation syndrome showed significant morphologic changes in cell size (polymegethism) and shape variability (pleomorphism); these changes were essentially the same in overtly affected and apparently normal fellow eyes. The results suggested that the corneal endothelial changes are consistent and might serve as an early sign of the disorder.