Age-related changes of the corneal endothelium and stroma as seen in vivo by specular microscopy

Two age-related changes of the human cornea are revealed in vivo by specular microscopy, (1) loss (and enlargement) of endothelial cells and (2) wrinkling of the posterior corneal layers when the cornea is applanated. A comparison of the rate of loss of cells and the effect upon the morphology of the endothelium as determined in several studies, indicates that cell loss and enlargement are rapid in the first year of life, slower up to the age of about 25 years, and fairly stable thereafter. In some individuals the remaining cells appear to enlarge regularly and in others irregularly. Posterior wrinkles on applanation of the cornea occur in the adult cornea only, and suggest an increasing rigidity of the stroma with increasing age.