Eye Bank Techs Match Trained Analysts in Determining Endothelial Cell Density

Well-trained eye bank (EB) technicians are as capable at determining endothelial cell density (ECD) as experienced analysts at an image analysis reading center when using the same image analysis method, according to a study recently published in Cornea.

To evaluate agreement between eye banks and an image analysis reading center on ECD determinations, the investigators had a single experienced analyst at The Cornea Image Analysis Reading Center (CIARC) determine ECD using the Konan center analysis method on EB-obtained central endothelial images from donors (intended for keratoplasty) from 2 eye banks, Eversight and Lions VisionGift. They also had experienced EB technicians determine ECD on images using the same analysis method. 

Investigators analyzed samples from 200 donors (average age 54 years, 29% with diabetes, 35% women). The mean ECD determined by EB technicians was 10 cells/mm² greater than that determined by the CIARC analyst (P =.39), with 95% limits of agreement of (2304 to 2323 cells/mm²). When the results were adjusted for donor sex, age, diabetes, coefficient of variation, percentage of hexagonal cells, and number of cells analyzed, the mean difference in ECD was not significantly changed (estimated mean difference, 20 cells/mm²; P =.73). The preoperative ECDs determined by EB technicians were within 10% of those determined by the CIARC analyst 89% of image sets, while 8% were higher by 0.10% and 3% were lower by 0.10%.

Limitations of the study included differences in training between eye bank technicians, differing image selection, varying methods of image analysis, and selection bias for cells analyzed.

“To the best of our knowledge, this is the first study to report ECD agreement between multiple eye banks and a central image analysis reading center using the same image analysis method by trained eye bank technicians and an image analyst from a central image analysis reading center,” according to the researchers.

Reference

Huang H, Benetz BA, Clover JM, et al. Comparison of donor corneal endothelial cell density determined by eye banks and by a central image analysis reading center using the same image analysis method. Cornea. Published online November 24, 2021. doi:10.1097/ICO.0000000000002935