Prenatal and postnatal cellularity of the human corneal endothelium. A quantitative histologic study.

The authors studied the cellularity of the normal corneal endothelium by histologic methods in 56 specimens from 16 weeks of gestation to 98 years of age. Ten step-serial sections were taken from each specimen through the central 6 mm of the cornea, in an area measuring 1.8 mm. The number of nuclei were counted on each section and a ratio of the number of nuclei per 100 micron of endothelial length was determined. This ratio provides a measure of cell density that they call cellularity. There is a decrease in cellularity that proceeds in a nonlinear manner and at a very rapid rate during the prenatal period and for the first few years of life. Cell death or necrosis, which might have contributed to this apparent loss of cells, was not observed. Instead, this rapid change in cellularity is correlated with a concomitant change in corneal size. The authors' calculations show that cell division may play a minor role in the formation of the endothelium after the second trimester of fetal life as most of the cells present by birth already exist by this time. After the first few years of life, the rate of change in endothelial cellularity decreases to proceed in a linear manner for the rest of the near 100 years of life examined. This latter age-related decline in cellularity is probably due to the loss of 0.56% cells per year from the endothelial layer, since the cornea does not appear to change in size during this time. Statistical analysis of the authors' data shows that these results are highly significant.