A comparison of corneal endothelial morphology in cornea guttata, Fuchs' dystrophy and bullous keratopathy.
Changes on corneal endothelial specular microscopy were compared in 14 patients with cornea guttata, 4 patients with Fuchs' corneal dystrophy and 19 patients with various forms of bullous keratopathy. The patients with cornea guttata showed well marked guttae 1 to 6 endothelial cells in diameter in the endothelial mosaic and in the relief mode while the endothelial mosaic was usually otherwise within normal limits. In 2 patients with Fuchs' dystrophy the endothelium could be examined, showing gross guttae but a few areas of relatively normal endothelial cells. The unaffected eye of 3 other patients showed findings similar to cornea guttata, but with some reduction in endothelial cell count in 2 patients. The patients with bullous keratopathy fell into 2 groups, one with gross reduction in cell count in a markedly abnormal endothelial cell mosaic, the other a mixed group with moderate reduction in cell count and numerous guttae. Some miscellaneous cases included one of aphakic peripheral bullous keratopathy, one associated with cyclitis and aphakia and 2 with idiopathic non-surgical bullous keratopathy. We believe the corneal endothelium is not grossly abnormal away from the guttae in Fuchs' dystrophy, but the gross guttata formation determines the endothelial dysfunction.
Brooks
A M
AM
Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Grant
G
G
Gillies
W E
WE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D003316:Corneal Diseases / Q000209:etiology / Q000473:pathology*; D003317:Corneal Dystrophies, Hereditary / Q000473:pathology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications