The posterior surface of the cornea in the irido-corneal endothelial syndrome: a specular microscopical study.

The corneal endothelia of 21 eyes afflicted with the irido-corneal endothelial (ICE) syndrome have been studied repeatedly with the clinical specular microscope. In all cases a characteristic cell type (the 'ICE-cell') is present but distributed in 4 different patterns. Accordingly, each case could be classified at any one time as one of 4 endothelial variants. One variant, always associated with elevated intraocular pressure (IOP), is characterised by a scattering of ICE-cells throughout the endothelial mosaic. This progresses rapidly to a second variant in which the entire endothelium appears 'replaced' by ICE-cells. In a third variant, associated with normal IOP, ICE-cells 'replace' only a portion of the endothelium which itself shows a great increase in cell numbers/unit area. This, apparently, slowly progresses to a fourth variant which shows a dramatic loss of endothelial cells.