The Specular Microscopy Reading Center (SMRC), established in 1989 at Case Western Reserve University and University Hospitals Case Medical Center, has participated in numerous corporate and federal clinical studies requiring standardized determination of corneal endothelial cell density and morphology.

The SMRC is a shared resource of the hospital and its academic partner, Case Western Reserve University School of Medicine. The Center is led by its Medical Director, Jonathan Lass, MD., Charles I Thomas Professor and Chairman of the CWRU Department of Ophthalmology and Visual Sciences and Director of the University Hospitals Eye Institute, and Technical Director, Beth Ann Benetz, C.R.A, F.O.P.S., Associate Professor of Ophthalmology at CWRU.

Clinical trial standards require cell counts to evaluate the safety of

• topical/subconjunctival/intravitreal medications
• solutions
• corneal preservation media
• intraocular devices
• assessing new surgical techniques

The capabilities of the SMRC include collection and analyses of pre-, during and post-cell changes of the endothelium. The SMRC has developed external calibration techniques that allow us to analyze images from a variety of specular microscopes and confocal instruments.

The SMRC has experience with multi-center, national and international clinical trials. The SMRC conducts focused web trainings detailing study-specific procedures for image capture, export and upload to the reading center.

The SMRC is unique in its use of a dual-grading reading method, whereby all images are read and analyzed by two separate readers, ensuring the validity of the image analysis (Current Eye Res 31:1-9, 2006).

The SMRC was the reading center for the Specular Microscopy Ancillary Study of the Cornea Donor Study, a National Eye Institute sponsored 5 year, 1100 patient multi-center study examining the effect of donor age on graft survival and endothelial cell loss.

Results of this study showed not only that donor age had no effect on graft success in patients undergoing penetrating keratoplasty for primary endothelial failure (Ophthalmology 115:620-26, 2008), but also endothelial cell loss is comparable (Ophthalmology 115:627-32, 2008). This study has been extended for another 5 years to continue to examine effect of age on graft and endothelial survival, as well as other donor and recipient factors.