Corneal Endothelial Morphology and Central Corneal Thickness in Pseudoexfoliation Syndrome

Abstract

Pseudoexfoliation syndrome (PXF) is an age-related systemic disorder characterised by the progressive deposition of abnormal fibrillar material in the anterior segment. Corneal endothelial involvement in PXF may have implications for endothelial reserve and intraocular surgery. This study aimed to evaluate corneal endothelial cell morphology and central corneal thickness (CCT) in patients with PXF. This hospital-based observational cross-sectional study evaluated 50 eyes of patients with clinically visible PXF. Patients with a history of intraocular surgery, glaucoma, contact lens wear, or corneal dystrophies were excluded. Endothelial cell density (ECD), percentage hexagonality, coefficient of variation (CV), and CCT were quantitatively assessed using a non-contact specular microscope (TOMEY EM-4000). Data were analysed using SPSS version 19, and correlations were assessed using Pearson’s correlation coefficient. The mean age was 63.48 ± 6.13 years, and 62.0% of the cohort was female. Mean endothelial cell density was 2266.74 ± 476.35 cells/mm², mean hexagonality was 40.70 ± 6.55%, and the mean coefficient of variation was 41.76 ± 6.94%. Mean central corneal thickness was 503.00 ± 35.79 μm. This study describes corneal endothelial morphology and central corneal thickness in eyes with PXF. The findings highlight the value of endothelial assessment in characterising this population. The absence of an age-matched control group limits conclusions regarding PXF-specific changes.