Objective: To study the density and morphology of corneal endothelium in patients with primary glaucoma.

Methods: 125 eyes of 68 patients with glaucoma were compared with 63 eyes of 32 patients without glaucoma in the same age group. Exclusion criteria included history of corneal disease, ocular inflammation, trauma, contact lens wearing and surgery. The following date were recorded: type and duration of glaucoma, glaucoma medications, and intraocular pressure (IOP) measurement. Non-contact specular microscope was performed on the central cornea, endothelial images were analyzed by computer.

Results: Corneal endothelium density was significantly lower in patients with glaucoma[(2386.81 +/- 289.76)/mm2] than that in controls [(2540.78 +/- 195.66)/mm2]. Cell density of primary angle-closure glaucoma(PACG) [(2262.65 +/- 338.64)/mm2] was significantly low, especially in acute PACG[(1925.16 +/- 403.38)/mm2]. The area of endothelium became bigger than normal. But the endothelium density and morphology of primary open-angle glaucoma(POAG) and non-acute PACG had no changes. No correlation was found between mean recent IOP and endothelium density.

Conclusions: This study suggested that patients with acute PACG might have lower corneal endothelium density and bigger cell area than those without glaucoma in the same age group. The endothelium density and morphology of POAG and non-acute PACG were as similar as those of normal persons.