Indian Journal of Ophthalmology

: 1985  |  Volume : 33  |  Issue : 4  |  Page : 221--223

Changes in the corneal endothelial cell count as a function of age

A Panda, K Venkataswarlu, SK Angra, M Mohan 
 Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences Ansari Nagar, New Delhi, India

Correspondence Address:
A Panda
Dr. Rajendra Prasad Centre for Ophth. Sc. AllMS, New Delhi-29

How to cite this article:
Panda A, Venkataswarlu K, Angra S K, Mohan M. Changes in the corneal endothelial cell count as a function of age.Indian J Ophthalmol 1985;33:221-223

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Panda A, Venkataswarlu K, Angra S K, Mohan M. Changes in the corneal endothelial cell count as a function of age. Indian J Ophthalmol [serial online] 1985 [cited 2021 Sep 28 ];33:221-223
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Full Text

Corneal endothelial cell density estima­tion for normal subjects have been previously reported by several authors. Cell density was found to decline with age[1],[2],[3],[4],[5],[6],[7],[8],[9]. The density falls by 30-50% between the ages of 20 and 80 years[6]. There is no statistical significant differences between the sexes nor between the two eyes.

The purpose of this present communica­tion is to present data on normal intra and interindividual variations in persons of different age groups.


A total of sixty normal subjects ranging in age from 8 to 72 years were studied. Both eyes of each subject were examined by the clinical contact spcular microscope P.R.O. model. The central areas, of each eye of each subject, considered to be a circle of 2mm radius on the endothelium concentric with the optic axis of the eve is examined. Prior to this examination a complete systemic and ocular history was obtained to ensure absence of any ailments.


The age groups of the subjects are as highlighted in [Table 1]. The decline of cell density is evident from [Figure 1]. This indica­tes that there is an abrupt fall of cell count upto age of 20 years and thereafter the curve shows gradual decline. The statistical analysis of the cases is shown in [Table 2].


Adequate function of the endothelial cells is necessary for a perfectly clear cornea. A cornea may remain clear after significant cell loss, but perhaps lose function at some future date if a critical number of cells do not remain. Specular microscopy helps to estimate the morphology and cell count of the corneal endothelium in vivo long before clinical signs of decompensation occur and is useful for the selection of eyes for intra­ocular surgery in general and foreseeing the prognosis in cases of donor corneas.

The decrease in cell density with age has been found by several authors, although the magnitude of this decrease differs consider­bly among different investigators. In a study of necropsy eyes Irvine & Irvine[2] found no age dependent variations in cell density. On the other hand a very large dependence was reported by Laule[3]. The great variation in cell density among different individuals needs to be stressed.

The first reports on the use of specular microscopy by Lang[5] and Bourne & Kauf­man[9] showed a reduction of in vivo cell count with age. While, Capella[4] commented that the morphological charac­teristics of the endothelium remain fairly consistent between the ages of 15-50, but at about 60-65 years individual cells begin to increase in size. Laing[5] was not in agreement with Capella[4] and commented that as age advances the cell changes occur gradually and progressively and not suddenly. A later study by Laule[3] demonstrated a steep decline in cell count with age up to the age of 25 years followed by a more gradual decline in subsequent years. Some Workers showed a reduction of endothelial cells until the fifth decade but no subsequent fall there­ after[6],[7].

The present study also shows this varia­tion. The mean cell count was found to decrease significantly (P<0.001) with increas­ing age of the subject up to 30 years of age. Thereafter the cell counts keep on reducing but are not statistically significant except at 70 years of age (P<0.05). However, a broad range of mean cell counts was found in all age groups. The total fall of mean cell count in right eye left eye was 35% & 34% respec­tively. A comparison between the mean cell counts from the right & left eyes of each subject showed a close agreement. This is in agreement with Sturrock[8] but not with Laing[5] who described a significant difference between two eyes.

Lastly, corneal endothelial cell count is useful for the selection of eyes for intra. ocular surgery and prior to instillation of some specific local drops and for prognostic point of view. However, as the critical number of cells yet to be determined for the maintainance of clarity and functional status of the cornea, there remains the necessity for cell density estimations for research.


The endothelium of 120 corneas of 60 normal individuals, the age group of 8-72 years were studied in vivo with specular microscope. It showed an abrupt decline of the cell count up to the age of 20 years and thereafter there is a gradual reduction of cell number with increasing age. The signi­ficance of these data is discussed. The importance of cell count measurement is commented.


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2Irvine, I.R and Irvine, I.R, 1953, Amer. J. Ophthalmol, 36: 1
3Laule A, Cable, M.K. Hoffman, L.E. and Hana C. 1978, Arch. Ophthalmol. 96: 2031.
4Capella J.A. 1971, Amer. J. Ophthalmol 3, 397.
5Laing R. A., 1976, Exp. Eye Res. 22 : 587.
6Wilson R. and Roper-Hall M.J., 1982, Brit J Ophthalmol, 66 :513.
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