Cornea Research Foundation of America, Indianapolis, IN 46260, USA.
Cornea. 2013 May;32(5):567-73. doi: 10.1097/ICO.0b013e31825de8fa.
To compare automated endothelial cell density analysis with manual cell detection methods with 3 imaging devices.
In this prospective study, the corneal endothelium of 54 Descemet stripping endothelial keratoplasty (DSEK) eyes and 28 normal eyes was analyzed with a Nidek Confoscan 4 confocal microscope using a 20× noncontact lens and with Tomey EM-3000 and Konan Noncon Robo SP-8800 specular microscopes. Testing order was randomized. The Confoscan and Robo images were presented in a blinded fashion to an experienced technician for manual cell identification and analysis using the manufacturer's software. A different operator determined endothelial cell density using fully automated software associated with each imaging device. Agreement between methods was assessed by repeated-measures analysis of variance and post hoc Tukey analysis.
Manual cell identification on Robo and Confoscan 4 images produced comparable cell density measurements in normal eyes (P = 0.73) and DSEK eyes (P = 0.11). The Confoscan automated cell detection software differed significantly from manual cell detection in both normal and DSEK eyes (P = 0.0003 and P < 0.0001, respectively). The Robo automated cell detection software produced results comparable with manual cell detection in normal eyes (P = 0.082) but significantly overestimated cell density in DSEK eyes (P < 0.0001). The EM-3000 automated cell detection produced results comparable with manual cell detection in normal eyes (P = 0.067) and DSEK eyes (P = 0.49).
Only 1 of 3 automated cell detection programs produced cell density readings comparable with those obtained with manual cell identification; the other 2 automated programs significantly overstated endothelial cell density in DSEK eyes.
比较 3 种成像设备的自动内皮细胞密度分析与手动细胞检测方法。
在这项前瞻性研究中，使用尼德克 Confoscan 4 共焦显微镜、Tomey EM-3000 和 Konan Noncon Robo SP-8800 共焦显微镜，分别使用 20×非接触镜对 54 例 Descemet 撕囊内皮角膜移植术（DSEK）眼和 28 例正常眼的角膜内皮进行分析。测试顺序是随机的。将 Confoscan 和 Robo 图像以盲法呈现给一位经验丰富的技术人员，使用制造商的软件进行手动细胞识别和分析。另一位操作人员使用与每种成像设备相关的全自动软件来确定内皮细胞密度。通过重复测量方差分析和事后 Tukey 分析评估方法之间的一致性。
在正常眼（P = 0.73）和 DSEK 眼（P = 0.11）中，Robo 和 Confoscan 4 图像的手动细胞识别产生了可比的细胞密度测量值。在正常眼和 DSEK 眼中，Confoscan 自动细胞检测软件与手动细胞检测均有显著差异（P = 0.0003 和 P < 0.0001）。Robo 自动细胞检测软件在正常眼中的结果与手动细胞检测结果相当（P = 0.082），但在 DSEK 眼中显著高估了细胞密度（P < 0.0001）。EM-3000 自动细胞检测在正常眼（P = 0.067）和 DSEK 眼（P = 0.49）中的结果与手动细胞检测结果相当。
只有 3 种自动细胞检测程序中的 1 种程序产生的细胞密度读数与手动细胞识别获得的读数相当；另外 2 种自动程序在 DSEK 眼中显著高估了内皮细胞密度。
