Central corneal mechanical sensitivity in pseudoexfoliation syndrome

Purpose: Corneal involvement and disturbances of the tear film have been reported in pseudoexfoliation syndrome (PEX). Tear film deficiencies are correlated with changes in corneal sensitivity. The present study aims at evaluating central corneal mechanical sensitivity (CCMS) in PEX. Methods: Patients with unilateral or bilateral PEX findings constituted the study group (SG). Age- and gender-matcbed patients without PEX in either eye constituted the control group (CG). Patients with conditions affecting corneal sensitivity were excluded. CCMS and central corneal thickness (CCT) were measured (using a Cochet-Bonnet esthesiometer and an ultrasonic pachymeter, respectively). Schirmer (ST) and break-up time (BUT) tests were also performed. Results: The SG included 40 patients (24 male, 60%). The CG included 38 patients (25 male, 65.78%). ST scores were significantly lower in the SG compared with the CG (11.45 +/- 2.52 mm and 14.27 +/- 1.18 nun, respectively, P = 0.04). BUT scores were also significantly lower in the SG compared with the CG (7.64 +/- 2.37 mm and 12.43 +/- 3.14 mm, respectively, P = 0.03). CCMS was significantly (P = 0.02) reduced in the SG compared with CG (4.54 +/- 0.23 cm and 5.73 +/- 0.44 cm, respectively). Differences in CCT between the SG and the CG were not statistically significant. Conclusions: The decrease in CCMS in PEX eyes may be related to decreased BUT and ST scores in PEX, as previously described. However, a direct involvement of sensory nerves may also participate. The reduction in CCMS may have implications for the clinical management of PEX patients.