Qualitative Characterization of Some Pathologic Corneal Diseases Using Contact Specular Microscopy

Abstract

The endothelium is a single layer of hexagonal cells lining the posterior surface of the cornea. It is responsible for the deturgescent state of the transparent cornea. Specular microscopy quantitative analysis of the endothelium is the latest method for its examination though this has not been found to be entirely predictive of corneal conditions that progress to corneal decompensation or edema. This study examined qualitative parameters to determine the association between corneal specular microscopy findings and progression or outcome of trauma (surgery) on the endothelium which causes corneal edema. Using the Konan SP5500 contact type of Specular microscope, the five areas (superior, central, inferior, temporal and nasal) of the corneal endothelium were examined. The following parameters were used: 1) regularity of posterior endothelial surface, 2) clarity of cells and their borders, 3) polymegethism and pleomorphism, and 4) presence of the intra, extra and intercellular bright or dark structures. Results showed that there were some parameters associated with prognosis of the corneal endothelium, namely: 1) the severity of endothelial surface irregularities, 2) the degree of polymegethism and pleomorphism (% of hexagonal cells), 3) the presence of early and late excrescences and inflammatory bodies, and 4) the area with the above findings. Qualitative analysis showed that area characterization is important to predict progression and outcome of corneal disease or conditions which may help in the prognostication of the corneal endothelium.

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