Ontology type: schema:Chapter
2017
AUTHORSKaterina Jirsova , Jameson Clover , C.G. Stoeger , Gilles Thuret
ABSTRACTThis chapter describes the three main microscopic approaches used to assess corneal quality prior to grafting: slit lamp microscopy, transmitted light microscopy, and specular (i.e., reflection) microscopy. Slit lamp microscopy is preferably used to evaluate the cornea and the surrounding parts of the eye soon after enucleation or to assess a cornea placed in a viewing chamber during hypothermic storage. This approach allows signs of previous surgery, stromal opacities, epithelial defects, foreign bodies, or an abnormal corneal shape to be detected. Transmitted light microscopy is typically used to assess corneas during organ culture storage, while specular microscopy is generally used to evaluate corneas stored in hypothermic media. When an eye bank distributes corneas for different types of surgery (penetrating or lamellar keratoplasty), a careful examination helps to match the available tissue with the requirements of different surgical techniques and thus to optimize the utilization of a limited resource. Although all of the corneal layers, including the epithelium and the stroma, need to be evaluated if the cornea is intended for penetrating keratoplasty, the assessment is primarily focused on the corneal endothelium. The open system of organ culture allows the visualization of dead endothelial cells using trypan blue vital staining and of the cell borders using hypotonic solution. Recent technical progress allows the endothelium to be evaluated by various image analysis systems connected to user-friendly software programs that employ semiautomatic or fully automatic algorithms for cell assessment. More... »
PAGES59-74
Light and Specular Microscopy of the Cornea
ISBN
978-3-319-48843-1
978-3-319-48845-5
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DOIhttp://dx.doi.org/10.1007/978-3-319-48845-5_4
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