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GP Holley, PE Sugarman, AR Purohit, HF Edelhauser; Endothelial Cell Density Is Significantly Increased In The Far Peripheral (Limbal) Region Of The Human Cornea . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3176.
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Purpose: To morphometrically assess the central, paracentral, and far peripheral (limbal) regions of the normal human corneal endothelium. Methods: Optisol-GS stored human corneas (n=50) were obtained from the Georgia Eye Bank (storage time less than 10 days). The age range was 3-75 years. The corneas were flattened with 4 radial incisions and stained for 5 minutes with 1% Alizarin red dye. Three or more photographs were taken with a Zeiss light microscope of the central, paracentral (2.0-2.5 mm from center) and far limbal (next to Schwalbe's line) endothelial regions of each cornea along with a calibration slide. The photos were enlarged, and at least 90-100 contiguous clumped cells were traced and digitized (corners method) to yield cell density (CD), coefficient of variation of cell area (CV), and hexagonality (% Hex). The data was stratified by region and age (decades in years). Means and standard error of the mean were calculated along with p values. Results: The overall central CD was 2463±87 cells/mm squared versus 2946±129 and 3790±158 for the paracentral and limbal regions, respectively. This constituted a 19.6% increase (p=0.0017) for paracentral vs. central and a 53.9% (p=0.0001) increase for the limbal region compared to the central. There was no significant difference in %Hex or CV between the central and paracentral, however, there was a 15% decrease (59±1.2 vs. 50±1.1, p=0.0001) in % Hex and a 14.2% increase (0.303 vs. 0.353) in CV comparing the central and limbal regions. When comparing by age, the limbal CD was higher (in each decade) than the paracentral CD, which was higher than the central CD. Also, there was a decrease in cell densities by age from younger to older corneas in all regions. The central had a 0.69% drop per year, paracentral 0.55% per year, and the limbal region 0.28% per year. Conclusion: The data from this morphometric evaluation suggests that the corneal endothelium has a potential limbal regeneration zone (very high cell density, high CV, low %Hex), a paracentral storage zone, and a central migration zone.
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