Specular microscopy in patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma

PURPOSE: To evaluate specular microscopic parameters in patients with pseudoexfoliation (PEX) syndrome and pseudoexfoliative glaucoma. METHODS: The study included 193 patients (249 eyes); 94 eyes with PEX syndrome, 71 eyes with PEX glaucoma and 84 normal eyes. Corneal endothelial cell density, coefficient of variation, percentage of hexagonal cells and central corneal thickness were recorded using a non-contact specular microscope (Konan CellChek XL). Results were compared statistically between groups, p<0.05 was considered significant. RESULTS: The mean age of participants was 68.91 ± 7.09 (52 – 85) with % 44.2 woman and % 55.8 men. There was significant difference in mean age between PEX glaucoma and control group (p=0.001). Endothelial cell density were significant lower in PEX group and PEX glaucoma group compared with normal eyes (p=0.002 and p=0.000). There was a significant decrease in percentage of hexagonal cells between PEX glaucoma and control group (p=0.004). Central corneal thickness were significant lower in PEX glaucoma group compared with PEX group and control group (p=0.005 and p=0.004). There were no significant differences in mean coefficient of variation between three groups (p>0.05). In PEX glaucoma group, there was no correlation between results and duration of anti – glaucomatous treatment, number of active substances (r≤0.03) CONCLUSIONS: Endothelial cell density and percentage of hexagonal cells were significatly decreased in PEX eyes, particularly in eyes coexisting glaucoma. Early damage assessment is possible in these patients using specular microscope. Therefore the risk of corneal decompensation can be reduced by taking special precautions during preoperative planning and during intraocular surgery and wise selection of topical anti–glaucomatous drops. KEYWORDS: Pseudoexfoliation, glaucoma, corneal endothelium, specular microscope