Hisham A. Saad, MD, Christopher Stoeger, CEBT
endothelial keratoplasty, microkeratome, vital stain, slit lamp, specular microscopy
PURPOSE: To describe a case where specular microscopy data relayed misleading information regarding the quality of a cornea processed in an eye bank for endothelial keratoplasty.
METHODS: A cornea was prepared by microkeratome for endothelial keratoplasty and was evaluated with routine slit lamp and specular microscopy. In addition, the tissue was stained with trypan blue and alizarin red S to demonstrate the efficacy of the preliminary evaluation with endothelial viability studies. The stained cornea was photographed, and the percent cell death was calculated using Adobe Photoshop analysis.
RESULTS: The preresection central endothelial cell density was 2608 cells/mm2. In comparison, the post-cut density was 2978 cells/mm2, a figure that represents a 14.19% cell gain. Viability staining with analysis showed 43.77% cell damage.
CONCLUSIONS: Reliance on specular microscopy for determination of endothelial viability can lead to misleading conclusions, as demonstrated in this case study.
doi:10.7706/ijeb.v1i2.27
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