European study on reliability assessment of endothelial cell count in eye banks: the Euro‐Keratotest study

Abstract

AbstractPurpose In European eye banks, 15‐20% of corneas are discarded for inappropriate ECD. Given the importance of a precise, robust and reproducible ECD, we organized an international survey of the quality of ECD determinationMethods The Euro‐Keratotest study reproduced 2 surveys driven in 2003 and 2008 by our team in the 18 French eye banks (Transplantation2004), with substantial improvements: test slides (3rd generation keratotests) were fabricated with technologies employed in micro‐optics, from images of real human corneas (Optics Letters2012). Twelve different mosaics with ECDs covering the usual range observed in eye banks, were created in a 8x8 mm quartz square. Keratotests, observable with transmitted light or specular microscopes, were sent simultaneously to all volunteer eye banks (n=100). Each technician had to determine ECD and morphometry of the 12 mosaics with his/her standard counting method. Data were collected on a specific websiteResults A first analysis of 120 technicians of 38 eye banks will be presented. It allowed identification of inter and intra bank variability and of bias likely involved (inappropriate counting strategy or wrong microscope calibration) and susceptible to be improvedConclusion Participation of the eye banks to this survey using 3rd generation keratotests improves our knowledge on the reliability of cell counting methods in eye banks, and help standardize graft quality assessment. Keratotests are also perfect tools for the initial formation and continuous training of eye banks technicians, as well as for the eye banks certification. Grant: Interregional Hospital Clinical Research Project 2011, Ministry of Health, DIRC Rhônes‐Alpes