F.Fazel MD  The corneal specular microscope is a reflected- light microscope that projects light onto the cornea and images the light reflected from.

Slides:



Advertisements
Similar presentations
Femtosecond Laser–Assisted Sutureless Anterior Lamellar Keratoplasty
Advertisements

Farid Karimian M.D. Department of Ophthalmology
Very simple to create with each dot representing a data value. Best for non continuous data but can be made for and quantitative data 2004 US Womens Soccer.
Microscopy.
Contact lenses Week 2.  Tear film consists of three layers with a pH level of 7.3 and a salt concentrations of 0.91 to0.97%. Normal evaporation is 1.
Asymmetric Keratoconus Study: Novel Tomographic Parameters to enhance sensitivity to detect abnormalities in eyes with normal axial curvature maps from.
Post-Mortem Ultra-Structural Analysis of a Cornea Transplanted With DMEK Jack Parker Jr, MD; Eitan Livny, MD; Vasilis S. Liarakos, MD, PhD; Gerrit R. Melles,
Endothelial Cell Changes as an Indicator for Upcoming Allograft Rejection Following Descemet Membrane Endothelial Keratoplasty Jack Parker Jr, MD; Lamis.
L 31 Light and Optics-3 Images formed by mirrors
Corneal topography orbscan
Hemi-DMEK Transplantation: Novel Method to Increase the Pool of Endothelial Graft Tissue Lam FC 1-4, Baydoun L 2-4, Dirisamer M 2-4, Lie J 2-4, Dapena.
The Human Eye
Comparison of Endothelial Cell Count by Manual and Automated Methods in Normal Corneas and in Fuchs' Endothelial Dystrophy Somasheila I Murthy, Debarun.
Endothelium Protection In Phacoemulsification H.R. Ziai MD.
Unit Ten: The Nervous System: B. Special Senses
TELEMEDICINE IN THE MODERN EYE BANK Eric Abdullayev MD, MBA,CEBT International Sight Restoration Eye Bank (ISR), Tampa FL, USA Author Has No Financial.
Early Outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty in Pseudophakic Eyes with Anterior Chamber Intraocular Lenses Preeya K. Gupta.
Katsuya Yamazoe, MD, Takefumi Yamaguchi, MD, Kazuki Hotta, MD, Yoshiyuki Satake, MD, Kenji Konomi, MD, Seika Den, MD, Jun Shimazaki, MD Presented by: Abdulrahman.
How you See The eye & vision. How You See The eye collects light from objects and projects them on the light-sensitive portion of the eye, the retina.
V. S. Liarakos, K. van Dijk, L. Ham, L. Baydoun and G.R.J. Melles Anterior Chamber vs Posterior Chamber IOL in DMEK for Pseudophakic Bullous Keratopathy.
Protecting the Corneal Endothelium
L 33 Light and Optics [3] images formed by mirrors –plane mirrors –curved mirrors Concave (converging) Convex (diverging) Images formed by lenses the human.
Ultrasound biomicroscopy is a new imaging technique that uses high frequency ultrasound to produce images of the eye at near microscopic resolution.
Cornea Implants Topics: Structure of the cornea
Intacs Insert name/ Practice name/ Logo here if desired.
USE OF THE KONAN NONCON-ROBO SPECULAR MICROSCOPE IN CLINICAL RESEARCH
Clinical Specular Microscopy Corneal Endothelial Cell Morphology
Incisional Procedures Insert name/ Practice name/ Logo here if desired.
Basic Contact Lenses COT/COMT Review.
Richard Y. Hwang 1, PhD; Dan Gauthier 2, PhD; Dana Wallace 1, MD; Natalie A. Afshari 1, MD 1 Department of Ophthalmology, 2 Department of Physics Duke.
Wavefront Sensing of the Human Eye
Somasheila I. Murthy, Prashant Garg, Pravin K. Vaddavalli
Dept. of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. Outcome after big-bubble deep anterior lamellar keratoplasty.
Deep Stromal Dissection for Endothelial Keratoplasty Obtained with a Femtosecond Laser and a Microkeratome with Different Head Advancement Speeds. A Scanning.
Evaluation of Corneal Parameters and Spherical Aberration After DSAEK Measured with Pentacam System Orkun Muftuoglu, Pawan Prasher, R. Wayne Bowman, Steven.
Evaluation of Interface Reflectivity and Corneal Aberrations following DSAEK Hamid Khakshoor, MD Professor of Ophthalmology Mashhad University of Medical.
Corneal dystrophies & other miscellaneous corneal conditions MBBS KGMU.
The authors have no financial interest in the subject matter of this poster Yinfei Xu, Peter S. Hersh, MD, David S. Chu, MD Institutional Affiliations.
Bowman’s layer Descemet’s membrane. Pathologic Diagnosis Diagnosis – Pseudophakic bullous keratopathy with Chronic bullous keratopathy Degenerative pannus.
Visualization of Epithelial Downgrowth of Inferior Angle, Iris, and Corneal Endothelium With Means of Endolaser Probe Mahmoud A. Khaimi, MD J. Matthew.
Effects of Intracameral Moxifloxacin, Levofloxacin, and Cefazolin on Corneal Endothelial Cells in Rabbits Su-Young Kim, Department of Ophthalmology and.
The eye is the photosensory organ of the body. It is composed of three tunics (coats): 1.Fibrous coat (sclera and cornea) forming the tough outer coat.
Endothelial Keratoplasty in Patients With an Anterior Chamber Intraocular Lens: A Montreal Experience Georges M. Durr, MD 1,2 Johanna Choremis, MD, FRCSC.
Confocal scan study of corneal grafts following Descemet-on versus Descemet-off deep anterior lamellar keratoplasty Zare M, Feizi S, Rezaie M, Hoseini.
E-Poster Price Vision Group & Cornea Research Foundation of America Descemet - Stripping Endothelial Keratoplasty :Survival Outcomes in Eyes with Pre-
1 Non-contact Specular Microscopy for Evaluation of Corneal Endothelium in Early Fuchs’ Endothelial Corneal Dystrophy Jianyan Huang 1, MD, PhD; Tudor Tepelus.
G. BAÏKOFF MD, Ch. AUBERT The author is a consultant for Carl Zeiss Meditec Clinique Monticelli – Marseille - France
Successful Use of Corneal Tissue from LASIK Donors in Descemet-Stripping Automated Endothelial Keratoplasty: A Case Series Mark D. Mifflin, MD Majid Moshirfar,
J. Brian Foster, MD No Financial Disclosures
Rio de Janeiro Corneal Tomography and Biomechanics Study Group CORNEAL TOMOGRAPHY AND BIOMECHANICAL FINDINGS OF CONCOMITANT KERATOCONUS AND CORNEAL GUTTATA.
Epithelial Dendritic Cells and Subbasal Nerve Plexus in Infectious Keratitis: An In Vivo Confocal Microscopy Study. Andrea Cruzat, MD, Dimos Mantopoulos,
Thomas John, MD Clinical Associate Professor Loyola University at Chicago Maywood, Illinois Ritika Patel Chicago Medical School.
Diminished Endothelial Cell Counts in Corneas with Krukenberg Spindles Authors: Tod M. Haller1, Chad B. Haller2, Melvin L. Haller1, Judah Beck3, Keith.
JI LOPEZ, CAMILLE JI LORENZO, ADRIAN
The authors have no conflicting interest in the subject matter of this poster. In Vivo Evaluation of DSAEK Interface with Scanning- Laser Confocal Microscopy.
CORNEAL ENDOTHELIAL PROFILE AFTER FERRARA RING IMPLANTATION Leonardo Torquetti, MD, PhD Paulo Ferrara, MD, PhD Paulo Ferrara Eye Clinic Belo Horizonte.
Date of download: 6/29/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Anterior Keratocyte Depletion in Fuchs Endothelial.
Fuchs’ Corneal Dystrophy
Comparison of Endothelial Cell Loss After Phacoemulsification Performed by Third Year Residents and Anterior Segment Surgeons Alexandra Braunstein, MD.
Corneal Endothelium Single layer of cells on the inner surface.
From: Staining Ability and Biocompatibility of Brilliant Blue GPreclinical Study of Brilliant Blue G as an Adjunct for Capsular Staining Arch Ophthalmol.
The Human Eye
Moran Eye Center, University of Utah
Central Tendency Central Tendency – measures of location for a distribution Mode – the commonly occurring number in a data set Median – the middle score.
Current status of corneal xenotransplantation
How to Find Data Values (X) Given Specific Probabilities
Corneal Effects of 1.5% Levofloxacin Ophthalmic Solution (IQUIX®) in Humans Mark B. Abelson, MD1,2 Gail Torkildsen, MD2; Aron Shapiro2; Ingrid Lapsa2.
Michael R. Banitt, MD, João Baptista Malta, MD, Roni M
How Cells Tiptoe on Adhesive Surfaces before Sticking
Corneal abnormalities.
Presentation transcript:

F.Fazel MD

 The corneal specular microscope is a reflected- light microscope that projects light onto the cornea and images the light reflected from an optical interface of the corneal tissue, most typically the interface between the corneal endothelium and the aqueous humor.  Although specular microscopes have been used primarily to evaluate the corneal endothelium, the corneal epithelium and stroma as well as the crystalline lens can also be visualized and evaluated.

 Identifies abnormal endothelial structures.  Cell Conformation.  Miscellaneous Structures

 The central endothelial cells of young people with normal eyes are hexagonal and approximately the same size; the distribution of cell area is approximately Normal (Gaussian). With age, the average cell area increases, the cellular pattern becomes distinctly pleomorphic, and the cell size distribution becomes skewed toward larger cell areas. In young people with normal eyes the cell side lengths are all roughly equal. In older individuals, the side lengths lose this regularity and one sees an increasing variation.  As in the case with changes in endothelial cell size, alterations in shape have not been directly related to changes in the physiologic function of the affected cells.

 cell size (cell area or cell density).  polymegathism (variation of cell size such as coefficient of variation of mean cell area).  pleomorphism (variation of cell shape such as percent of hexagonal cells or coefficient of variation of cell shape).  Etc…

 mean cell area.  cell density or cell count.  Cell area has been expressed in units of µm² per cell and cell density in units of cells per mm².

 Endothelial wound healing mechanisms: sloughing & sliding, coalescence, and mitosis(in successful graft rejection only)

 Mean cell size is micrm2  From birth to adolescence the cell density decreases rapidly.  From age 20 through approximately age 50, endothelial cell density seems to be relatively stable. . After the age of 60, cell density decreases significantly in most people

 350,000 cell / cornea  at birth, cell / mm 2  at middle age, 2500 cell / mm 2  at old age, 2000 cells / mm 2

 In EDC between cll per mm2 corneal edema ocures.  Cell loss 0%-30% in anterior segmen surgery.  At least EDC of is needed for safe AC surgery.  Polymorphism and polymegatism above 0.40 or hexagonal shape less than 50% is abnormal and risk.

 Cornea guttate, characteristic for Fuch’s endothelial dystrophy, are focal accumulations of collagen on the posterior surface of Descemet's membrane that apparently are formed by stressed or abnormal endothelial cells; they appear as warts or excrescences of Descemet's membrane and can easily be seen with specular microscopy. Cornea guttate also occur as a result of aging and corneal inflammation.

 Density  Polymegathism:Coefficient of variation(mean cell area/standard deviation of mean cell area)normally less than  Percentage of hexagonal cell.  Pleomorphism(cell shape).

Yoji Kushino TOMEY CORPORATION

★ Built in analysis software 1 Cell number 2 Cell Density (pcs/mm2) 3 Cell area (Average、maximum、minimum) 4 Standard deviation 5 Coefficient of variation 6 Histogram(Cell area and cell stroke count) 7 Percentage of hexagon cell 8 Topography map