September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Techniques to perform Specular Microscopy: Endothelial Cell Counting (ECC) and Endothelial Mosaic Mapping (EMM)
Author Affiliations & Notes
  • Fernando Cesar Abib
    Clinic Hospital of Federal University of Parana, Curitiba, Parana, Brazil
    Cornea, Dr. Fernando Abib Eye Clinic, Curitiba, Brazil
  • Footnotes
    Commercial Relationships   Fernando Abib, Canada 2,604,371 (P), China 200580050169.7 (P), Japan 2008505698 (P), USA 7,957,915 B2 (P)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1930. doi:
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      Fernando Cesar Abib; Techniques to perform Specular Microscopy: Endothelial Cell Counting (ECC) and Endothelial Mosaic Mapping (EMM). Invest. Ophthalmol. Vis. Sci. 2016;57(12):1930.

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

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Purpose : The main task is to know the endothelial behavior to plan an objective way to perform the Corneal Endothelial Mosaic (CEM) examination. The CEM was described according the autor, ARVO 2015, into Regular, Irregular and Chameleon Pattern. The Regular Pattern can be examined by No Contact (NC) Corneal Specular Microscope (CSM), Irregular and Chameleon Patterns by Contact (C) CSM. This choice was based in how each type of CSM get the images: NC CSM acquire CEM images when the patient sets the target light, each model of this type of CSM has fixed positions; C CSM can acquire CEM of any area of the endothelial surface by sliding the objective lens on the cornea. Considering the differences this study to presents a guideline to perform Specular Microscopy choosing the best technique for CEM description.

Methods : All CSM were colleted in 2013 at the Dr. Fernando Abib Eye Clinic, Curitiba, Brazil. The choose of the NC CSM (CSO, Italy) or C CSM (BioOptics, USA) was determined by the algorithm (Figure1A). The number of counted cells in each examination was guided by Reliability Indexes of the Cells Analyzer USA Patent software program (Technicall, Brazil) to obtain sample error < 5% counting more endothelial cells than the calculated sample size considering all endothelial cells inside of the different images as necessary (Figure1B). The results were reported in terms of the examinations performed for Endothelial Cell Count or Endothelial Mosaic Mapping, respective clinical situations, and used CSM, utilizing descriptive statistics.

Results : 879 CSM were performed in 2013; 556 (63.2%) were performed for ECC finality and 323 (36.8%) for EMM: 91 (28.2%) CSM with EMM finality could be performed with NC CSM or C CSM to correct ECC and 232 (71.8%) of than with only C CSM to correct but with focal description of the ECC. Number of examinations: Clinical situations 21 (8.8%) for ECC and 217 (92,2%) for EMM; Refractive situations: 370 (91.8%) for ECC and 33 (8.2%) for EMM; Other non refractive surgical situations: 165 (69.3%) for ECC and 73 (30.7%) for EMM.

Conclusions : The ECC was the most frequent finality of the CSM (63.2%) and performed with NC CSM. A high number of CSM needed the endothelial mapping (36.8%) to describe the reality of the CEM. We strongly suggest C CSM with endothelial mapping technique to perform CEM examination for Irregular and Chamaleon patterns .

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.




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