Abstract： Objective: To compare the differences in corneal endothelial morphology in pseudoexfoliation syndrome (PEX), pseudoexfoliation glaucoma (PEXG), primary open angle glaucoma (POAG) and age-related cataracts (ARC) in a Uyghur population. Methods: A retrospective study was conducted of patients that included 76 eyes with PEX, 82 eyes with PEXG, 64 eyes with POAG and 76 eyes with ARC who had received treatment from July 2019 to August 2020. Corneal endothelial cell density (ECD), coefficient of variation (CV) in cell size, and percentage of hexagonal cells (HEX) were measured using a non-contact specular microscope, while central corneal thickness (CCT) was measured with an anterior segment OCT. One-way ANOVA was used for comparison between multiple groups, and LSD-t test was used for pairwise comparison between groups. Results: The ECD was 2 565±202/mm2 , 2 286±178/mm2 , 2 104±376/mm2 , and 2 206±206/mm2 in the ARC, PEX, PEXG, and POAG groups, respectively. Compared with the ARC group, the ECD in the PEX, PEXG and POAG groups had all decreased, and the differences were statistically significant (t=5.16, 6.19, 6.58, P<0.001). The ECD in the PEXG group was lower than that in the PEX and POAG groups, but the differences were not statistically significant. The percentages of HEX were lower in the PEX, PEXG and POAG groups compared with the ARC group, while the CV in cell size was greater, the differences were statistically significant (P<0.001). The difference between the CCT in the PEX group and ARC group was not statistically significant. The CCT of the PEXG group was lower than that of the PEX group, and the difference was statistically significant (t=2.25, P=0.02). The CCT of the PEXG group had a downward trend compared with POAG, but the difference was not statistically significant. Conclusions: This research shows that in eyes with PEX syndrome, ECD is significantly descreased, and CCT is significantly thinner in PEXG eyes, suggesting that more attention should be paid to the protection of the cornea when performing surgical treatment on PEX patients.
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