Specular microscopy is a non-invasive photographic technology used to diagnose conditions and disease of the back surface of the cornea, known as the corneal endothelium. Because the corneal endothelium is responsible for maintaining proper corneal hydration, a cornea with a compromised endothelium can develop edema and lose its transparency.
Common ocular conditions such as glaucoma, uveitis and Fuchs endothelial dystrophy can produce changes in the structure and function of the corneal endothelium that can result in corneal edema and loss of vision. In addition, refractive surgeries such as Radial Keratotomy (RK), LASIK and intra-ocular surgeries may also compromise the corneal endothelium.
Specular microscopy allows us to visualize and analyze in great detail the corneal endothelium. With the use of a bio-microscpe and a special computer we are able to visualize and analyze the size, shape and population of the corneal endothelial cells. In clinical practice, specular microscopy is the most accurate way to examine the corneal endothelium. One additional piece of information: It is not unusual for a transplanted cornea to become cloudy with age. If this is the case, specular microscopy should be done on a periodic basis to make sure that the transplant is sound and not in danger of being rejected. This is done by counting the endothelial cells per square mm with the specular microscope. If the endothelial cell count is low, the transplanted cornea may lose its ransparency and be rejected.