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To the Editor.
—We would like to comment on the article: "Corneal Endothelial Changes With Long-Term Topical Epinephrine Therapy," by Waltman et al, in the August 1977 Archives (95:1357-1358). The authors found a notable reduction in the endothelial cell count in epinephrinetreated hypotensive eyes compared with untreated fellow controls, and the authors emphasized the relationship between epinephrine and endothelial cell loss. The epinephrinetreated eyes had lower tensions than the control eyes during the follow-up, but before treatment, the situation was probably the reverse. Therefore, we would like to point out that increased intraocular pressure (IOP) may also decrease the endothelial cell population.In animal experiments, Svedbergh and Bill (Acta Ophthalmol 50:321-336, 1972) showed that increased IOP, even for short periods, causes changes in the ultrastructure of the endothelial cells. Our group reports (Acta Ophthalmol, to be published) the study, with a specular microscope, of the endothelial cell densities of
Vannas A, Setälä K, Ruusuvaara P. Corneal Endothelial Changes With Epinephrine Therapy. Arch Ophthalmol. 1978;96(3):543. doi:10.1001/archopht.1978.03910050301030