Color Specular Microscopy of Disorders Involving the Corneal Epithelium

doi:10.1016/S0161-6420(84)34174-4

Ophthalmology

Volume 91, Issue 10, October 1984, Pages 1176-1183

https://doi.org/10.1016/S0161-6420(84)34174-4 Get rights and content

Abstract

Color specular microscopy, a noninvasive, in vivo microscopic technique, was utilized to study the corneal epithelium in 17 patients including eight with keratoconus, seven with bullous keratopathy, and two with Fuchs' corneal dystrophy. Color specular microscopy was also performed on rabbit corneas with experimental surgical trauma. Changes observed by specular microscopy in these diseased states correlated with alterations noted by light microscopy and scanning and transmission electron microscopy. Specular microscopy can provide detailed in vivo cellular morphology of the ocular surface, obviating the need for tissue biopsy. Thus, specular microscopy is a valuable diagnostic technique available for the clinician to monitor changes of the diseased ocular surface.

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Cited by (13)

Corneal epithelium 3 and 9 o'clock staining studied with the specular microscope
1994, International Contact Lens Clinic
Our purpose was to learn whether specular microscopy is useful in evaluating corneal epithelia with peripheral corneal desiccation (3 and 9 o'clock staining), which affects most rigid gas permeable contact lens wearers. The Keeler-Koran specular microscope was used to photograph corneas of 10 lens wearers and 10 control subjects. Photoanalysis revealed that lens wearers had reduced peripheral and increased central cell areas compared to control subjects, and corneal staining was correlated with decreased cell areas. Specular microscopy was found to be valuable for analyzing and quantifying the epithelium.
Specular microscopic evaluation of the corneal epithelium after excimer laser photorefractive keratectomy
1994, American Journal of Ophthalmology
Nineteen eyes underwent photorefractive keratectomy to correct myopia. Using the specular microscope, we observed the central corneal epithelium of each eye preoperatively and at one, three, and six months after surgery. A normal epithelial pattern was observed in 18 eyes (94.7%) at one and three months and in 19 eyes (100%) at six months after surgery. There was no statistically significant difference in the pre- and postoperative mean cell area and corresponding coefficient of variation. These results suggest that the destruction of Bowman's layer produced by photorefractive keratectomy does not affect the morphologic characteristics of the most superficial layer of the corneal epithelium.
Corneal epithelial changes after excimer laser photorefractive keratectomy
1993, American Journal of Ophthalmology
We used the specular microscope to investigate corneal epithelial changes after excimer laser photorefractive keratectomy. Thirteen patients underwent photorefractive keratectomy on one eye to correct myopia. We observed the central corneal epithelium of each eye at postoperative periods from one to 15 months after photorefractive keratectomy. The fellow eye served as a control. In 11 eyes (85%) the central cornea showed normal epithelial patterns. Two eyes had an abnormal epithelial pattern that included elongated epithelial cells. There was no difference in the mean cell area or coefficient of variation of mean cell area between the treated eyes and the control eyes. These results suggest that permanent destruction of Bowman's membrane caused by photorefractive keratectomy does not affect the morphologic characteristics of the most superficial layer of the corneal epithelium in most eyes. However, the presence of abnormal epithelial cell patterns in two patients should be considered a risk factor for this procedure.
Specular Microscopic Observation of Human Corneal Epithelial Abnormalities
1991, Ophthalmology
The diameter of the cone lens of the specular microscope was enlarged from its original size of 3.5 mm to 6.0 mm. This modification enabled the authors to take clear pictures of the corneal epithelium with a specular microscope (SM) contact lens, because tears could be excluded from the photographic field by exerting even pressure on the cornea. The normal corneal epithelium showed three kinds of cells with no abnormally shaped or reflex cells. As spindle-shaped cells were mainly observed in keratoconus patients, postpenetrating keratoplasty patients, and postepikeratophakia patients, this suggests that these cells may be an indicator of wound healing. Large cells were observed in diabetic aphakic patients, aphakic extended-wear soft contact lens wearers, and aphakic patients using 0.5% indomethacin eye drops; thus, the presence of large cells may indicate suppressed metabolism and mitosis. Colonies of small cells were observed in keratoconjunctivitis patients. Cells with nuclei and irregular cell patterns were observed in all diseased conditions. There are several common abnormal patterns in the corneal epithelium that are observable under the specular microscope. Modified specular microscopic observation can detect these subtle alterations at the cellular level.
The effects of extended-wear hydrophilic contact lenses on the human corneal epithelium
1986, American Journal of Ophthalmology
We used wide-field color specular microscopy of the human corneal surface to study the morphologic changes that occur under extended-wear contact lenses. There was a shift in the frequency distribution of surface cells by size to larger cells, suggesting a prolonged residence time on the ocular surface. Other abnormalities included retained desiccated mucin, coarse mucus plaques, and palisading of cells.
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: Presented at the Eighty-eighth Annual Meeting of the American Academy of Ophthalmology, Chicago, Illinois, October 30–November 3, 1983.

: Supported in part by NIH Grant ROI EY-4361-02 (Dr. Lemp) and a Grant from Research to Prevent Blindness (Dr. Lemp).

^*: Cornea Service, Center for Sight, the Georgetown University Medical Center, the Clinical Branch, National Eye Institute, Bethesda, Maryland

^†: Belo Horizonte, Brazil

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Color Specular Microscopy of Disorders Involving the Corneal Epithelium

Abstract

Am J Ophthalmol

Ophthalmology

Specular microscopy of corneal epithelium

Arch Ophthalmol