Scheimpflug Camera Measurement of Optical Density of the Corneal Epithelium, Stroma, and Endothelium in Patients with Pseudoexfoliation Syndrome

BACKGROUND: The present study evaluated the optical density of particular layers of the cornea and anterior lens capsule in patients with pseudoexfoliation syndrome (PEX). MATERIAL/METHODS: Sixty patients with cataract and PEX (mean age 76.6±5.6 years, range 62–88 years) were compared to 55 controls with cataract without PEX syndrome (mean age 76.3±6.09 years, range 62–90 years; P>0.05). The anterior segment of one eye was examined in each patient using Pentacam HR by Oculus before the planned cataract surgery. RESULTS: The average optical density of the corneal epithelium, stroma, and endothelium was 25.3±6.09% and 19.9±3.41% (P<0.001), 23.1±5.5% and 19.2±3.6% (P<0.0001), and 14.6±3.4% and 12.3±2.1% (P<0.0001) in the PEX and control groups, respectively. The optical density of the anterior lens capsule was 13.6±4.2% in the PEX group and 9.74± 2.23% in the control group (P<0.0001). The average thickness of the cornea was 555 μm and 556 μm and the average optical density of endothelial cells 2240/mm(2) and 2323/mm(2) in the PEX and control groups, respectively (P<0.05). CONCLUSIONS: In patients with PEX, increased optical density was observed not only in the structures with pseudoexfoliative material detectable by a slit-lamp), but also in the corneal epithelium and stroma. The increased optical density was not associated with reduced endothelial cell density or increased central cornea thickness.