Automatic Determination of Endothelial Cell Density From Donor Cornea Endothelial Cell Images.

Purpose: To determine endothelial cell density (ECD) from real-world donor cornea endothelial cell (EC) images using a self-supervised deep learning segmentation model.

Methods: Two eye banks (Eversight, VisionGift) provided 15,138 single, unique EC images from 8169 donors along with their demographics, tissue characteristics, and ECD. This dataset was utilized for self-supervised training and deep learning inference.

Deep learning segmentation of endothelial cell images using an active learning paradigm with guided label corrections.

Purpose: To create Guided Correction Software for informed manual editing of automatically generated corneal endothelial cell (EC) segmentations and apply it to an active learning paradigm to analyze a diverse set of post-keratoplasty EC images.

Approach: An original U-Net model trained on 130 manually labeled post-Descemet stripping automated endothelial keratoplasty (EK) images was applied to 841 post-Descemet membrane EK images generating "uncorrected" cell border segmentations. Segmentations were then manually edited using the Guided Correction Software to create corrected labels.

Comparison of Donor Corneal Endothelial Cell Density Determined by Eye Banks and by a Central Image Analysis Reading Center Using the Same Image Analysis Method.

Purpose: The purpose of this study was to evaluate agreement between eye banks (EBs) and an image analysis reading center on endothelial cell density (ECD) determinations using the same image analysis method.

Methods: The Cornea Image Analysis Reading Center (CIARC) determined ECD with a single experienced analyst on EB-obtained central endothelial images from donors intended for keratoplasty from 2 eye banks, Eversight and Lions VisionGift, using the Konan center analysis method. The EBs performed ECD determination on their respective sets of images using the same analysis method with experienced eye bank technicians.

Quantitative and qualitative evaluation of deep learning automatic segmentations of corneal endothelial cell images of reduced image quality obtained following cornea transplant.

We are developing automated analysis of corneal-endothelial-cell-layer, specular microscopic images so as to determine quantitative biomarkers indicative of corneal health following corneal transplantation. Especially on these images of varying quality, commercial automated image analysis systems can give inaccurate results, and manual methods are very labor intensive. We have developed a method to automatically segment endothelial cells with a process that included image flattening, U-Net deep learning, and postprocessing to create individual cell segmentations.

Comparative corneal endothelial cell toxicity of differing intracameral moxifloxacin doses after phacoemulsification.

Purpose: To determine whether intracameral moxifloxacin 500 μg is noninferior to 250 μg for central endothelial cell loss (ECL) after phacoemulsification.

Setting: Aravind Eye Care System.

Design: Prospective masked randomized study.

Machine learning for segmenting cells in corneal endothelium images.

Images of the endothelial cell layer of the cornea can be used to evaluate corneal health. Quantitative biomarkers extracted from these images such as cell density, coefficient of variation of cell area, and cell hexagonality are commonly used to evaluate the status of the endothelium. Currently, fully-automated endothelial image analysis systems in use often give inaccurate results, while semi-automated methods, requiring trained image analysis readers to identify cells manually, are both challenging and time-consuming.

Postoperative Endothelial Cell Density Is Associated with Late Endothelial Graft Failure after Descemet Stripping Automated Endothelial Keratoplasty.

Purpose: To determine whether preoperative endothelial cell density (ECD) and postoperative ECD after Descemet stripping automated endothelial keratoplasty (DSAEK) are associated with late endothelial graft failure (LEGF) in the Cornea Preservation Time Study (CPTS).

Design: Cohort study within a multicenter, randomized clinical trial.

Participants: A total of 1007 individuals (1223 study eyes), mean age 70 years, undergoing DSAEK for Fuchs' dystrophy (94% of eyes) or pseudophakic or aphakic corneal edema (PACE) (6% of eyes) and followed for up to 5 years.

Corneal Endothelial Cell Density and Morphology After Phacoemulsification in Patients With Primary Open-Angle Glaucoma and Cataracts: 2-Year Results of a Randomized Multicenter Trial.

Purpose: To evaluate corneal endothelial cell density (ECD) and morphology 2 years after phacoemulsification in subjects from the COMPASS trial (ClinicalTrials.gov, NCT01085357) who had mild-to-moderate primary open-angle glaucoma and visually significant cataracts.

Methods: The central corneal endothelium was evaluated by serial specular microscopy at 0 to 24 months.

Donor, Recipient, and Operative Factors Associated With Increased Endothelial Cell Loss in the Cornea Preservation Time Study.

Importance: Determining factors associated with endothelial cell loss after Descemet stripping automated endothelial keratoplasty (DSAEK) could improve long-term graft survival.

Objective: To evaluate the associations of donor, recipient, and operative factors with endothelial cell density (ECD) 3 years after DSAEK in the Cornea Preservation Time Study.

Design, Setting, And Participants: This cohort study was a secondary analysis of data collected in a multicenter, double-masked, randomized clinical trial.

Effects of Repeated Intravitreal Aflibercept Injection on the Corneal Endothelium in Patients With Age-Related Macular Degeneration: Outcomes From the RE-VIEW Study.

Purpose: The effects of repeated intravitreal aflibercept injection (IAI) on the corneal endothelium were studied in patients with unilateral neovascular age-related macular degeneration.

Methods: RE-VIEW was a phase 4, open-label, single-arm, multicenter study. Patients received IAI every 8 weeks after 3 monthly doses.

Descemet's stripping automated endothelial keratoplasty: three-year graft and endothelial cell survival compared with penetrating keratoplasty.

Purpose: To assess 3-year outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) in comparison with penetrating keratoplasty (PKP) from the Cornea Donor Study (CDS).

Design: Prospective, multicenter, nonrandomized clinical trial.

Participants: A total of 173 subjects undergoing DSAEK for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic corneal edema) compared with 1101 subjects undergoing PKP from the CDS.

Effect of incision width on graft survival and endothelial cell loss after Descemet stripping automated endothelial keratoplasty.

Purpose: To assess the effect of incision width (5.0 and 3.2 mm) on graft survival and endothelial cell loss 6 months and 1 year after Descemet stripping automated endothelial keratoplasty (DSAEK).

Descemet's stripping automated endothelial keratoplasty outcomes compared with penetrating keratoplasty from the Cornea Donor Study.

Purpose: To assess outcomes 1 year after Descemet's stripping automated endothelial keratoplasty (DSAEK) in comparison with penetrating keratoplasty (PKP) from the Specular Microscopy Ancillary Study (SMAS) of the Cornea Donor Study.

Design: Multicenter, prospective, nonrandomized clinical trial.

Participants: A total of 173 subjects undergoing DSAEK for a moderate risk condition (principally Fuchs' dystrophy or pseudophakic/aphakic corneal edema) compared with 410 subjects undergoing PKP from the SMAS who had clear grafts with at least 1 postoperative specular image within a 15-month follow-up period.