Background: PEX syndrome significantly influences cell density of corneal endothelium of people with this disease. The clinical uses of cell analysis include the assessment of donor corneal endothelium, effects of intraocular surgery and is essential in evaluating the safety of corneal surgical procedure. The aim of present study to evaluated the qualitative and quantitative changes of corneal endothelial cells in pseudoexfoliation syndrome.

Material & Methods: The present study was conducted in Department of Ophthalmology, Government B.D. hospital, Churu, Rajasthan. This was randomized and single site study to evaluate qualitative and quantitative changes of corneal endothelial cells in pseudoexfoliation syndrome with or without glaucoma by specular microscopy in Indian study population. We included 40 patients and randomized them in to 2 groups of 20 patients each as follows: Group A having Young healthy person serving as control group and Group B having psuedoexfolation syndrome group.

Results: Our study showed that the maximum subjects (n=15) in 55-65 years in age in control group and 8 patients in 66-75 years in age in psuedoexfoliation syndrome group. Male to female ratio was 3:2 in control group and 1.22:1 in PSX group. The mean value of endothelial cell density (cells/mm²) in normal subjects were 2511±171.3 and compare to mean value (2124±116.0) of psuedoexfolation syndrome group was statistically significant (p<0.0001***), cell size variation coefficient in psuedoexfolation syndrome group was statistically significant (p<0.0001***), The hexagonalty (%) statistically significant (p<0.0001***), but Central corneal thickness (µm) in normal subjects were 530.8±26.20 and compare to mean value (524.8±16.19) of psuedoexfolation syndrome group was statistically insignificant (p=0.3892 NS).

Conclusion: This study confirms the existence of qualitative and quantitative modifications in endothelial cells of eyes with PEX, particularly when IOP is high. It could also indicate a possible independent biological role of CCT as a risk factor for the development of glaucoma in subjects with PXS.

Keywords: Psuedoexfoliation syndrome, Center corneal thickness, Intraocular pressure, Hexagonalty.

1. Lindberg JG: Kliniska undersokningar over depigmenteringen av pupillarranden och genomlysbarheten av iris vid fall av aldersstarr samt i normala ogon hos gamla personer. In [Clinical studies of depigmentation of the pupillary margin and transillumination of the iris in cases of senile cataract and also in normal eyes in the aged] [Thesis]. Helsinki, Finland: Helsinki University; 1917.
2. Cahill M, Early A, Stack S, Blayney AW, Eustace P: Pseudoexfoliation and sensorineural hearing loss. Eye (Lond) 2002, 16(3):261-6.
3. Alfaite M, Leite E, Mira J, Cunha-Vaz JG: Prevalence and surgical complications of Pseudoexfoliation syndrome in Portuguese patients with senile cataract. J Cataract Refract Surg 1996, 22:972-6.
4. Lumme P, Laatikainen L: Exfoliation syndrome and cataract extraction. Am J Ophthalmol 1993, 116:51-5.
5. Aasved H: Mass screening for fibrillop-athia epitheliocapsularis, so-called senile exfoliation or pseudoexfoliation of the anterior lens capsule. Acta Ophthalmol (Copenh) 1971,49 (2):334-43.
6. Schlötzer-Schrehardt UM, Dörfler S, Naumann GO. Corneal endothelial invol-vement in pseudoexfoliation syndrome. Arch Ophthalmol. 1993;111:666–74.
7. Klemetti A. Intraocular pressure in exfoliation syndrome. Acta Ophthalmologica. 1988;66(184):54–58.
8. Arvind H, Raju P, Paul PG, Baskaran M, Ramesh SV, George RJ et al. Pseudoexfoliation in south India. Br J Ophthalmol. 2003;87(11): 1321-1323.
9. Shazly AT, Farrag AN, Kamel A, Al-Hussaini AK. Prevelance of Psuedoex-foliation syndrome and psuedoexfoliation Glaucoma in upper Egypt. BMC Ophthalmology. 2011: (6) 1471-2415.
10. Schlötzer-Schrehardt U, Naumann GO. Ocular and systemic pseudoexfoliation syndrome. The American Journal of Ophthalmology. 2006;141(5):921–933. 
11. Naumann GO, Schlötzer-Schrehardt U, Küchle M. Pseudoexfoliation syndrome for the comprehensive ophtalmologist. Intraocular and systemic manifestations Ophthalmology. 1998;105(6):951–968.
12. Bożydar T. Tomaszewski,^*Renata Zalewska, and Zofia Mariak. Evaluation of the Endothelial Cell Density and the Central Corneal Thickness in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma.J Ophthalmol. 2014; 2014: 123683.
13. Quiroga L, Lansingh VC, Samudio M, Pena FY, Carter MJ. Characteristics of the corneal endothelium and pseudoexfoliation syndrome in patients with senile cataract; Clin Experiment Ophthalmol.2010,jul;38(5):449-55.
14. Zimmermann N, Wünscher M, Schlötzer-Schrehardt U, Erb C. Corneal endothelial cell density and its correlation with the severity of pseudoexfoliation; 2014 Feb;231(2):158-63.
15. de Juan-Marcosa,b,∗, L. Cabrillo-Estéveza, F.A. Escudero-Domíngueza, A. Sánchez-Jaraa, E. Hernández-Galilea. Morphometric changes of corneal endothelial cells in pseudoexfoliation syndrome and pseudoexfoliation glaucoma. a r c h s o c e s p o f t a l m o l . 2 0 1 3;8 8(1 1):439–444.
16. Acar BT, Buttanri IB, Sevim MS. Evaluation of anterior segment parameters in pseudoexfoliation syndrome patients. Turkish Journal of Ophthalmology. 2010;40(4):217–222.

Dr. F.H. Gauri

Principal Specialist (M.D. Medicine),

Government D.B. General Hospital, Churu, Rajasthan

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.