Materials and Methods: This retrospective study included patients who underwent cataract surgery. The study analyzed 33 patients with unilateral pseudoexfoliation syndrome (PES), including eyes with pseudoexfoliation (Group 1) and their fellow eyes without pseudoexfoliation (Group 2). In addition, 75 eyes of 54 patients with pseudoexfoliative glaucoma (Group 3) and 72 eyes of 36 healthy individuals (Group 4) were included. All eyes underwent SM to assess central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV), and hexagonality percentage (HEX).

Results: The mean ages were similar among the groups, with no significant differences (p = 0.512). Mean ECD values were 2494.6 ± 426.6, 2521.8 ± 455.8, 2322.0 ± 492.2, and 2556.1 ± 401.0 cells/mm² in Groups 1?4, respectively. PEG eyes had significantly lower ECD compared to controls, while no significant difference was observed between PES eyes and their fellow eyes. CV, HEX, and CCT did not differ significantly among groups. In the PEG group, retinal nerve fiber layer (RNFL) thickness showed a positive correlation with CCT, whereas visual field mean deviation (MD) demonstrated a negative correlation with CCT. No significant correlations were found between RNFL or MD and ECD, CV, or HEX.

Conclusion: ECD was significantly reduced in PEG eyes compared to controls, suggesting endothelial damage may be more associated with glaucoma than PES. Keywords : Endothelial cell density, Pseudoexfoliation glaucoma, Pseudoexfoliation syndrome, Specular microscopy