Confocal and Transmission Electron Microscopic Features of Endothelial Vacuolation in Donated Corneas

To report the confocal microscopic features of endothelial vacuolation in donated corneas and to confirm the observed changes by transmission electron microscopy. Confocal and transmission electron microscopy were performed on donated corneas with endothelial vacuole formation on slitlamp biomicroscopy. The ultrastructural findings were also compared with those of a normal-looking endothelium from a keratoconic cornea. Confocal microscopy revealed large numbers of dark round to oval-shaped structures within the endothelium, consistent with vacuolation which was confirmed by light and electron microscopy by the presence of variable-sized cyst-like structures within the endothelial cytoplasm mainly near the posterior cytoplasmic membrane in semithin preparations and observation of electron-lucent and relatively large-sized intracytoplasmic vacuoles on transmission electron microscopy. These features were not observed in the normal-looking endothelium of a keratoconic cornea. In this report, confocal microscopic features of endothelial cell vacuolation are presented in donated corneas and confirmed by transmission electron microscopy. The confocal microscopic images can serve as a useful reference image for endothelial vacuolation.