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March 1994

Corneal Endothelial Involvement in Pseudoexfoliation Syndrome

Author Affiliations

Oslo, Norway

Arch Ophthalmol. 1994;112(3):297. doi:10.1001/archopht.1994.01090150027002

In one of the latest issues of the Archives, Schlötzer-Schrehardt et al1 claimed to provide evidence that pseudoexfoliation (PSX) material may be derived from the corneal endothelium. The conclusion was based on findings in two corneal buttons with Fuch's dystrophy and one enucleated, glaucomatous eye.

Although I have no doubt about their observations, I was rather surprised by the interpretation by Schlötzer-Schrehardt et al.1 They state: "The [corneal] endothelial cells generally contained numerous phagocytosed melanin granules and occasionally intracellular vacuoles with fibrillar contents." They also observed what they called desquamating endothelial cells characterized by large quantities of phagocytosed melanin granules.

It is an old clinical observation that PSX fragments may stick to the corneal endothelium in eyes with PSX syndrome. Since PSX iris specimens flourish on corneal stroma substrate in vitro,2 it seems likely that the authors describe aqueous-borne pigment epithelial cells (from the iris or the

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