Corneal endothelial involvement in pseudoexfoliation syndrome
U. M. Schlotzer-Schrehardt, S. Dorfler and G. O. Naumann
Department of Ophthalmology, University of Erlangen-Nurnberg, Germany.
Information on corneal manifestation in pseudoexfoliation syndrome is
restricted to specular microscopic studies. We investigated morphologic
changes of the posterior cornea of two corneal buttons with Fuchs'
endothelial dystrophy obtained at penetrating keratoplasty and of one
enucleated glaucomatous eye from three patients with ocular
pseudoexfoliation syndrome. By transmission electron microscopy, large
clumps of typical pseudoexfoliation material were found adhering to the
corneal endothelium and masses of pseudoexfoliation material were
incorporated into the posterior Descemet's membrane. In the affected areas,
the endothelial layer appeared irregular and discontinuous, with loosely
adherent, degenerating cells producing pseudoexfoliation fibers and
fibroblastic cells spreading to cover denuded Descemet's membrane. The
present findings indicate that the pseudoexfoliation material is initially
formed by degenerative endothelial cells and that it becomes subsequently
buried by overgrowing cells. The corneal endothelial involvement may
potentiate complications of cataract surgery and open angle glaucoma in
patients with pseudoexfoliation syndrome.
