Abstract：Objective: To evaluate the repeatability and reproducibility of corneal endotheliumcells measured by slit-scanning wide-field contact specular microscopy (CellChek C), and to examine its the agreement with a noncontact specular microscopy (SP3000). Methods:This was a cross-sectional study.A total of 50 healthy subjects, including 38 males and 12 females, aged 50.7±20.2 years (ranging 19-79 years), who underwenthealth examination in the Eye Hospital of Ophthalmology and Optometry Wenzhou Medical University from May 2021 to May 2022, were consecutively selected. All subjects were examined by two examiners with CellChek C and SP3000 for corneal endothelial cell density (ECD), average cell size (ACS),thepercentage of hexagonalshape cells (HEX), coefficientof variation (CV). Within-subjectstandard deviation (Sw), test-retest repeatability (TRT), the within-subject coeffcient of variation (CoV) and the intra-class correlation coeffcient (ICC) were used to analyze reproducibility. Bland-Ahman was used to assess the agreement of the instruments. Results:The number of the cells used to analyze with CellChek C was significantly larger than SP3000 (559.9±56.5 cells vs.94.7±21.3 cells, P<0.001). The repeatability results of ECD and ACS measured by CellChek C and SP3000 were good. The TRTvalues and CoV valuesof ECDmeasured by the two instrumentswere 161.28 cells/mm2 and 173.72 cells/mm2, 2.17%and 2.42%, respectively, with good repeatability. The TRTvalues and CoVvalues of ACS were also with good repeatability, with result of 22.23 μm2and 30.94 μm2, 2.13% and 2.86%, respectively. The ICC were 0.928 and 0.922. The ICC of the percentage of HEX and CVmeasured by CellChek C are between 0.75 to 0.9. However, the repeatability of SP3000 for the HEX was poor (ICC=0.528). The reproducibility of ECD, HEX, ACS, CVmeasured by CellChek C were good. The ICC were 0.946, 0.914, 0.940 and 0.842, respectively. There were signifcant differences in the results of ECD (P=0.004), HEX (P<0.001),ACS(P=0.014) and CV(P<0.001) between the two instruments. The 95% LoAof ECD, HEX, ACS and CV werelarge(-293.3-458.5cells/mm2,-23.5-6.4%,-42.3-8.6μm2and0.7-27.8).Conclusions:CellChek C demonstrated good repeatability and reproducibility in measuring corneal endothelial cell parameters in healthy subjects. CellChek C have poor agreement with noncontact specular microscopy.
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