Endotheliometry

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What is the role of the endothelium?

The endothelium is the inner layer of the cornea. The main function of the endothelium is to remove the liquid (leaks) from the layer of the cornea thereby allowing the cornea to remain optically clear. Some diseases that cause damage to the endothelium, such as the Fuchs dystrophy, lead to endothelial damage and eventually to corneal edema. These patients usually require corneal transplant after the endothelial cells are not renewed satisfactorily when destroyed. Also, damage to the endothelium can occur either after trauma or after the removal of a very mature cataract which can lead to endothelial damage and eventually reduce the number of cells.

Sometimes, patients who undergo cataract surgery with a preoperative relatively small number of endothelial cells take longer to restore the corneal swelling after surgery. Younger patients recover relatively much easier after trauma endothelium because they have a greater number of endothelial cells compared to older patients.

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Why is endotheliometry important?

Knowing the number and condition of endothelial cells is crucial for a number of decisions we have to take (usually before surgery – the criterion for selecting the surgical method). The endothelial corneal cells have a hexagonal shape, and during childhood their number ranges from 3500 to 4000 per mm2. With advancing of the age, the number of cells is reduced so that adults have 1500 to 2000 cells / mm2.

Today, ophthalmologists base on endothelioscopy to examine the morphology of the enlarged endothelium and the number of its cells. Furthermore, with endotheliometry, the ophthalmologist is simultaneously updated for the thickness of the cornea and with some algorithms can determine the percentage of cells presenting different sizes and pleomorphism.

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