СORNEAL ENDOTHELIUM IN EYES WITH PSEUDOEXFOLIATION SYNDROME (DATA OF ENDOTHELIAL MICROSCOPY)

Abstract

Objective: To compare corneal endothelial indexes in eyes with pseudoexfoliation syndrome (PEX) and without it, and identify the dependence of corneal endothelial cell density (CD) on the age and stage of glaucoma. Patients and Methods: The study included 55 people (96 eyes). There were 53 eyes with PEX and 43 eyes without it. Patients were divided into 2 age groups: 40–60 years (41 eyes) and 61–80 years (55 eyes). The groups were homogeneous with respect to the level of IOP, Central corneal thickness, anteposterior axis of the eye and the stages of glaucoma. Endothelial microscopy was performed on a SP-3000P (Topcon). Statistical processing was made with SPSS 16.0 for Windows(methods of variation statistics, discriminant analysis). Results: There were significant difference in eyes with PEX and without PEX in CD in ages of 40–60 years (2309,57±87,77 cells/mm 2 and 2642,39±64,81 cells/mm 2 , p=0.005) and 61–80 years (2247,02±59,5 (cells/mm2 and 2590,18±93,39 cells/mm2, p=0.004), as well as in the average surface area of endothelial cell (434,08±17,43 µm 2 and 385,17±9,57 µm 2 , p=0,024; 461,14±15,23 µm 2 and of 395.00±13,21 µm 2 , p=0.002, respectively).There was age difference of CD reduction: the highest CD was at 40–50 years (2722.75±63.05 cells/mm 2 ), and at 81–90 years if fells to 1872.67±417.29 cells/mm 2 (at a given age are found only patients with PEX). Revealed that the CD is dependent on the stage of glaucoma: the density was highest in the absence of glaucoma (2603.00±162.61 cells/mm 2 ) and at an initial stage of glaucoma (2480.65±48.88 cells/mm 2 ), while the density was lowest at stage 3 of glaucoma (2118.73±150.51 cells/mm 2 ). Here reducing of the CD was due to patients with PEX, while in patients without PEX the differences were not statistically significant in different stages of glaucoma. Conclusion: Our study showed that the eyes with PEX are characterized by a more pronounced damage to the corneal endothelium, than eyes without it. The condition of endothelium cells worsens in eyes with PEX, depending on the age and stage of glaucoma. Thus, the performing of endothelial microscopy can be seen as a necessary tool in the monitoring of patients with PEG for the solution of a question on tactics of treatment and timely phacoemulsification.