Endothelial function in patients with cornea guttata.

Measurements of corneal thickness, endothelial cell size, endothelial permeability to fluorescein, and intraocular pressure were made in two groups of human subjects: 21 persons with cornea guttata (early Fuchs dystrophy without epithelial edema) and 17 persons age- and sex-matched but with normal corneas. Statistically significant differences were found between the two groups in all four measured variables. The two groups did not differ with respect to the variability in endothelial cell sizes. There were statistically significant positive correlations between endothelial permeability to fluorescein, endothelial cell size, and corneal thickness. The endothelial pump rate was calculated for each group, and the difference was not statistically significant. Our results suggest that the earliest defect in Fuchs' dystrophy is solely a breakdown in barrier function and thus increased permeability, resulting in a thicker cornea.