The Other Side of the Corneal Endothelium

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Abstract
New high-magnification biomicroscopes, the specular microscope and now the in-tandem confocal microscope, provide new images of the corneal endothelium in vivo. These are not always easy to interpret, and correlation with the morphology of the endothelium as seen in dead, fixed specimens is necessary. One such image is of the anterior surface with the confocal microscope. It exhibits a mosaic of hexagonal cells. This surface has not been specifically investigated previously in fixed preparations and the in vivo appearance does not correlate with the structure deduced from transmission electron micrographs. These indicate that the bases of endothelial cells are in the form of thin processes that would not present an image of clearly defined cell outlines. Therefore, the anterior surface of corneal endothelium stripped from ox and human corneas has been examined with the scanning electron microscope. It was found that the basal cell membranes extend processes to neighbouring cells and that some of these seem to unite. The possibility that these findings are artefactual has been examined by comparing them with published transmission and scanning electron micrographs, and it has been concluded that the processes of the basal cell membranes are real.

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