Determination of Corneal Endothelial Cell Count and Morphology in Patients with Pseudoexfoliation: A Cross-control Study

Abstract

Introduction: Pseudoexfoliation Syndrome (PEX) is characterised by the formation or deposition of abnormal fibrillar material on intraocular structures. Various ocular complications, such as chronic open-angle glaucoma, zonular dehiscence causing lens subluxation/dislocation, poor mydriasis are associated with PEX. In PEX eyes, corneal endothelial changes have been demonstrated along with thinner Central Corneal Thickness (CCT). Aim: To evaluate the CCT, corneal Endothelial Cell Density (ECD) and morphology in patients with pseudoexfoliation and to compare the results with age matched controls. Materials and Methods: A case-control study was done on a total of 147 eyes of 81 patients with pseudoexfoliation with equal number of eyes in age matched controls were evaluated for corneal ECD, coefficient of variation in cell size, percentage of hexagonal cells and CCT using a non-contact specular microsope. The quantitative data was represented as their mean±Standard Deviation (SD). The paired t-test was used for analysing quantitative data. Results: The average ECD in the PEX group was 2301.30±117.37 cells/mm2. It was significantly lower than the average ECD in controls 2632.91±24.04 cells/mm2 (p-value <0.001). The average CCT in the PEX group was 508±19.09 microns and in the age matched controls was 524.22±6.36 microns. The average CCT was low in the PEX group and difference was statistically significant (p≤0.001). The coefficient of variation and percentage of hexagonality were altered but did not show any statistical significance in both the groups. Conclusion: ECD and CCT is significantly decreased in eyes with PEX. Pleomorphism and polymegathism was not found significant in this study.