Keratopathy in Pseudoexfoliation syndrome

Abstract

Pseudoexfoliation Syndrome (PEX) engenders a distinctive ocular condition known as PEX‐associated keratopathy. This secondary corneal disorder arises from the abnormal accumulation of pseudoexfoliative material on the corneal endothelium, compromising its structural integrity and functional properties. Histopathologically, PEX deposits lead to alterations in endothelial cell morphology, with attendant changes in cell density and pleomorphism. These pathological shifts culminate in compromised pump function, disrupting the delicate balance of corneal hydration and leading to decreased transparency. Clinically, PEX‐associated keratopathy manifests as corneal guttae, a distinctive pattern of focal excrescences seen on specular microscopy. These endothelial excrescences contribute to diminished visual acuity and increased susceptibility to corneal decompensation. Furthermore, PEX‐associated keratopathy presents a unique set of challenges in the context of corneal surgery, necessitating meticulous preoperative evaluation and specialized surgical approaches. Thus, a nuanced understanding of the intricate relationship between PEX and its associated keratopathy is essential for optimizing the management and visual outcomes of individuals afflicted by this complex ocular syndrome.