As expected, striae were more prevalent in the worst quality images. The new classification presented in this study can easily encompass and categorize all possible artifacts in donor corneas’ specular microscopy, possibly providing a universal language on this subject. The number of striae was significantly higher in the poor + impossible images compared to the good + fair images in both groups 1 and 2 (p<0.01). The number of artifacts per image is shown in Tables 1 and 2 (plotted side by side for better comparison). The mean corneal storage time was 1.86 ± 1.21 days. Descriptive statistics and Mann-Whitney U test were used for statistical analysis (p<0.05). In addition, the quality of each image was classified according to McCarey’s review of corneal SM for FDA clinical trials into good, fair, poor or impossible. The gradient of colors represented the damage severity. Artifacts (Figure 1) were classified in: 1- Unicelullar: endothelial edema (EE) smaller or the same size as 1 endothelial cell (EC) 2- Paucicellular: EE between 2 and 10 EC in size (in this case, the approximate amount of EC fitting in the edematous area were counted) or guttae 3 – Multicellular (also called striae): EE greater than 10 EC in size (irregular outline) or a manipulation trail (regular outline).
#Artifact meaning in microscopy software
The images were semi-automatically analyzed by the manufacturer’s software (KONAN KSS-EB10) and evaluated by a trained physician. Four endothelial images were obtained from the central donor corneal area. All tissues were preserved in Eusol-C at 4☌ and heated to 27☌ before examination. This study proposes a classification for the different types of artifacts found in SM of donor corneas and quantifies them in a small sample.Ī trained eye bank technician performed specular microscopy (KeratoAnalyzer EKA-10 KONAN©) in 7 donor corneal tissues (mean age of 57.14 ± 6.12 years old) on the day of their arrival in the eye bank (group 1) and the day of their distribution (group 2). Artifact means any change in the structure or condition of the cells produced by artificial means, such as laboratory manipulation.
Some artifacts may arise and induce misleading information on SM data. However, corneal tissue is manipulated and submitted to different temperatures during this process. Though presence of artifact gives some clue in. Specular microscopy (SM) is widely used to analyze endothelium after processing and preservation of donor corneas. Most of the microscopic section show artifact, which play a important role in misinterpretation of diagnosis.
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