May 2004
Volume 45, Issue 13
ARVO Annual Meeting Abstract  |   May 2004
Endothelial Cell Density In Donor Corneas: A Comparison Of Automatic Software Programs With Manual Counting
Author Affiliations & Notes
  • C. Hirneiss
    Ophthalmology, Ludwig–Maximilians University, Munich, Germany
  • A.S. Neubauer
    Ophthalmology, Ludwig–Maximilians University, Munich, Germany
  • K. Hartmann
    Ophthalmology, Ludwig–Maximilians University, Munich, Germany
  • U. Welge–Luessen
    Ophthalmology, Ludwig–Maximilians University, Munich, Germany
  • A. Kampik
    Ophthalmology, Ludwig–Maximilians University, Munich, Germany
  • Footnotes
    Commercial Relationships  C. Hirneiss, None; A.S. Neubauer, None; K. Hartmann, None; U. Welge–Luessen, None; A. Kampik, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 4791. doi:
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      C. Hirneiss, A.S. Neubauer, K. Hartmann, U. Welge–Luessen, A. Kampik; Endothelial Cell Density In Donor Corneas: A Comparison Of Automatic Software Programs With Manual Counting . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4791.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: Manual cell counting is still the standard in eye banks for assessing the exact endothelial cell density (ECD) of donor corneas. However, recently several software programs have become available to measure the ECD automatically. Purpose of this study was to compare software programs, the Endothelial Analysis System EAT V1.4 (Rhinetec, Duesseldorf, Germany) and the NAVIS Cell Count Version 3.4.1 (Nidek Technologies, Erlangen, Germany) with manual counts of ECD in human donor corneas. Methods: A total of 50 human corneas were analyzed during organ culture. At the same time endothelial photography was performed on both, conventional film and digitally for all corneas. For each cornea, at least two photographs were counted manually three times by one experienced ophthalmologist (counting at least 100 cells per picture). The three digital pictures of each cornea were taken and analyzed automatically on a calibrated Rhinetec EAT system. All images were then imported to the NAVIS system. The fully automatic mode was applied and calibration was accounted for by a correction factor. In a further experiment on 11 corneas the NAVIS counts were directly compared to the manual counts of pictures taken on a calibrated Leica microscopy system. Results: The mean endothelial cell density obtained by manual counting was 2679 +/– 366 cells per mm2 (+/– SD). Values obtained by the digital analysis with the EAS V1.4 were mean 1.3% higher (2713 +/– 286 cells per mm2), but did not differ significantly. In contrast, analysis of the digital pictures with the NAVIS version 3.4.1 showed mean 7.0% higher measurements (2867 +/– 111 cells per mm2 ). On Altman–Bland Analysis it became obvious that for high ECDs the NAVIS system tended to give too low numbers, while for low ECDs too high results were given. This difference could be confirmed in the direct comparison with the Leica system. Conclusion: Automatic digital analysis offers a quick and reproducible method to determine ECD during organ culture and before surgery. In this study the Rhinetec system showed equal values to manual counting, while the Nidek software did not and had a systematic error. Independent validation of any automatic system against manual counting is therefore of vital importance. A new version of the NAVIS software which will correct for those errors will be available soon.

Keywords: cornea: endothelium 

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