SUMMARY The endothelium of the normal corneas of 67 human subjects was studied in vivo with the specular microscope in order to quantify the method as a means of sampling the cell density of the tissue. It was found that (1) axial cell counts of the endothelium are reproducible in the same cornea after an interval of time; (2) the cell counts of the centre and periphery of the same cornea are similar; (3) the axial cell counts of pairs of eyes are similar; and (4) there is a gradual reduction of cell number with increasing age. The significance of these data is discussed.
The literature suggests that posterior polymorphous dystrophy (PPD) may show features such as iridocorneal adhesions, glassy membranes, and pupillary ectropion which are typically ascribed to the iridocorneal endothelial (ICE) syndrome. This complicates diagnosis. PPD, unlike ICE, is familial, and ICE, unlike PPD, is usually progressive and frequently complicated by glaucoma: thus it is important to distinguish between them. To determine whether this could be achieved by specular microscopy, since the posterior corneal surface is abnormal in both conditions, 57 cases of ICE and 44 of PPD were repeatedly examined and photographed with the specular microscope. Progressive and/or static morphological features of the corneal endothelium and Descemet's membrane were found that were specific for each condition. Specular microscopy can thus provide a definitive diagnosis of ICE or PPD even in uncertain cases.
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