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Corneal endothelial validation in the eye bank: differences in automated methods and repeatability
B Vidal-Villegas1, B Burgos-Blasco1, P Fernandez-Vega2
1Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain.
Journal Francais D'Ophtalmologie
|November 11, 2023
Summary
Endothelial cell density (ECD) measurements are reproducible with both center and flex-center methods on the Konan Cell Check D. However, the flex-center method yields higher ECD, especially in corneas with low cell counts.
Area of Science:
- Ophthalmology
- Corneal Science
- Cell Biology
Background:
- Endothelial cell density (ECD) is a critical parameter for assessing corneal health and donor suitability.
- Specular microscopy is the standard method for quantifying ECD.
- Automated analysis software in specular microscopes aims to improve efficiency and reproducibility of ECD measurements.
Purpose of the Study:
- To assess the intergrader reproducibility of endothelial cell density (ECD) measurements using the Konan Cell Check D specular microscope.
- To compare the performance of two automated cell counting methods (center and flex-center) within the Konan Cell Check D software.
- To evaluate the reliability of coefficient of variation and hexagonality metrics in conjunction with ECD measurements.
Main Methods:
- 54 donor corneas were analyzed by two independent ophthalmologists using the Konan Cell Check D.
- Endothelial cell density (ECD) was quantified using both the 'center' and 'flex-center' automated counting modes.
- Intergrader reproducibility was assessed using the Intraclass Correlation Coefficient (ICC), and method comparison was performed using correlation coefficients.
Main Results:
- Good intergrader reproducibility was observed for ECD measurements with both the center (ICC=0.821) and flex-center (ICC=0.784) methods.
- Reliability for coefficient of variation and hexagonality was poor (ICC≤0.265).
- The flex-center method resulted in significantly higher ECD values compared to the center method (P=0.013), particularly in corneas with lower ECD (<2700 cells/mm²).
Conclusions:
- Endothelial cell density (ECD) measurements demonstrate good reproducibility with both automated methods on the Konan Cell Check D.
- The flex-center method tends to overestimate ECD, especially in corneas with low cell counts.
- Clinicians and eye banks should be cautious when interpreting small differences in ECD, particularly when using the flex-center method.
