Specular Microscopic Features of Corneal Endothelial Vacuolation

PURPOSE To introduce a specular microscopic reference image for endothelial vacuolation in donated corneas. METHODS Two corneas from a donor with diffuse, round to oval dark areas at the endothelial level on slit lamp biomicroscopy and one normal-appearing donor cornea underwent specular microscopy, histopathologic evaluation and transmission electron microscopy. RESULTS Specular microscopy of the two corneas with abnormal-looking endothelium revealed large numbers of dark, round to oval structures within the endothelium in favor of endothelial vacuolation. Light microscopy disclosed variable sized cyst-like structures within the cytoplasm. Transmission electron microscopy showed electron-lucent and relatively large-sized intracytoplasmic vacuoles. These features were not observed in the endothelium of the normal cornea. CONCLUSION The specular microscopic features of endothelial vacuolation in donated corneas were confirmed by light microscopy and transmission electron microscopy, therefore the specular image may be proposed as a reference to eye banks.