Specular microscopy 25/03/2013

Specular microscopy helps us to study the endothelial layer of the cornea. As cell distribution is almost uniform, via microscopy we can find out the number, shape and size of the endothelial population.

Specular microscopy provides a reflected image of the optical interphase between the endothelial layer of the cornea and the aqueous humour, although it can also be used to obtain images of the epithelium and of the corneal stroma, as well as the crystalline lens.

The normal endothelium of a young person has, in specular microscopy, a regular pattern of hexagonal cells, most of them of the same diameter, which can vary with age, trauma, pathologies or surgical procedures.

No contact is required to carry out this examination. The eye is centred using a placement light and it's advisable for the patient to blink several times before the image is captured to moisten the eye's surface and improve its reflective properties. Specular microscopy must be carried out as a non-invasive diagnostic tool to determine the state and physiological reserve of the endothelial cell layer as a transparent cornea does not guarantee the endothelial layer of the cornea is normal. We therefore carry this out systematically on our patients before cataract surgery and surgery to implant phakic lenses.