Endothelial cell count measures the number and morphology of cells in the corneal endothelium, the inner layer responsible for keeping the cornea clear. It is important before and after many intraocular procedures.
How it is Measured
Specular or confocal microscopy captures magnified images of the endothelial layer through the cornea. Software then calculates cell density, size variation, and shape regularity.
- Non-contact or contact instruments may be used
- Results are expressed as cells per square millimetre
- Normal counts decline slowly with age
- Marked loss or abnormality can lead to corneal oedema
Clinical Importance
Low endothelial counts increase the risk of corneal decompensation after surgery such as cataract extraction or intraocular lens exchange. Monitoring helps identify patients who may need modified techniques or combined corneal procedures.
- Essential in corneal dystrophies like Fuchs endothelial dystrophy
- Useful in evaluating transplant graft survival
- Can detect toxicity from intraocular medications or previous surgery
- Guides counselling about surgical risks and prognosis
