confocal and transmission electron microscopic features of endothelial vacuolation in donated corneas

purpose: to report the confocal microscopic features of endothelial vacuolation in donated corneas and to confirm the observed changes by transmission electron microscopy. methods: confocal and transmission electron microscopy were performed on donated corneas with endothelial vacuole formation on slitlamp biomicroscopy. the ultrastructural findings were also compared with those of a normal-looking endothelium from a keratoconic cornea. results: confocal microscopy revealed large numbers of dark round to oval-shaped structures within the endothelium, consistent with vacuolation which was confirmed by light and electron microscopy by the presence of variable-sized cyst-like structures within the endothelial cytoplasm mainly near the posterior cytoplasmic membrane in semithin preparations and observation of electron-lucent and relatively large-sized intracytoplasmic vacuoles on transmission electron microscopy. these features were not observed in the normal-looking endothelium of a keratoconic cornea. conclusion: in this report, confocal microscopic features of endothelial cell vacuolation are presented in donated corneas and confirmed by transmission electron microscopy. the confocal microscopic images can serve as a useful reference image for endothelial vacuolation.