The use of specular microscopy (SM) as a routine clinical method for qualitative morphological and quantitative morphometric analysis of the corneal endothelium requires a standardized examination technique. Organizational and apparative means are necessary for the analysis, documentation and storage of the data. The results of the immediate analysis are documented on a result form. The morphological changes are classified in 4 different groups (endothelial, pre-endothelial, retro-endothelial, and non-endothelial changes). The morphometric analysis is performed immediately: the mean cell density (mcd) is estimated by comparing the endothelial mosaic in the camera viewfinder with 3 standardized specular micrographs with known cellular density. The good correlation between the results of estimation and definite counting allows this rapid method to be used as a simple clinical screening techniques. The definitive morphometric analysis is carried out directly from the photographic negative using the fixed frame principle. The mcd and mean cell area (mca), m +/- sd, are determined by a simple method which saves time and money, using a scientific pocket calculator programmed in Basic. A specially designed slide rule serves to define the frame. The calculator may also be used for statistical analyses. This is demonstrated in a group of 127 patients (aged 51-87) before IOL implantation. The mcd and mca of the examined population is 2249 +/- 290 cells/mm2 and 444 +/- 57 microns 2. There is no statistically significant difference in mcd between the right and left eye (t-test: p = 0.93). Although statistically mcd decreases significantly with advancing age (p = 0.05), there is a large range of results in this population.(ABSTRACT TRUNCATED AT 250 WORDS)
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