Abstract
Purpose:
To evaluate the accuracy and efficacy of a new endothelial cell analyzing system (REA; robin GmbH, Germany) in comparison to a well-established endothelial cell image analyzing software (NAVIS, Nidek Technologies, Japan).
Methods:
Organ-cultured human donor corneas were evaluated by light microscopy after 6 hours of deswelling (CorneaJet, Eurobio, France). Endothelial cells counts were assessed with a computer-based fixed-frame method using automated and semi-automated algorithms of two endothelial cell analyzing systems (REA; robin GmbH, Germany versus NAVIS, Nidek Technologies, Japan). With the automated program, the computer software recognized single cells and estimated endothelial cell density based on the number of identified cells and their areas. For semiautomatic evaluation, the observer marked individual endothelial cells and the software subsequently calculated endothelial cell densities.
Results:
Based on endothelial cell image quality, both systems tended to show significant differences between the automated and semi-automated detected endothelial cell counts. In the majority, automated detected endothelial cell densities were lower with NAVIS software and higher using REA software compared to semi-automated endothelial cell analysis (range: 10 to 855 cells). Semi-automated cell counts were comparable between both systems.
Conclusions:
The new REA system provides an easy, efficient and reliable approach in image acquisition and endothelial cell analysis. However, semi-automated algorithms tend to be more accurate compared to automated algorithms in both technoligies. Therefore, manual correction of automated acquired endothelial cell images is still strongly recommended in evaluation of human donor corneas.