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The corneal endothelium of intact donor eyes was evaluated by means of a specular microscope. In a series of 278 corneas, different morphologic changes were found in the endothelium. These changes are described and systematically classified. The findings are analogous to results obtained on experimental animals and with light- and electron-microscopic studies of other authors.

Specular microscopy allows a direct evaluation of the corneal endothelium in intact donor eyes. It is therefore superior to previous methods for assessing donor material for penetrating keratoplasties. In a study of 278 eyes (139 donors) 226 could be examined by specular microscopy without any preparatory major manipulations. Twenty-four pairs and 12 single eyes (27%) of the 226 corneas were considered not suitable for grafts according to their morphologic endothelial changes. The discarded eyes were found all normal at conventional slit-lamp examination. Specular microscopy of the endothelium was not possible in 52 eyes as the corneal swelling was already too advanced.