Machine learning based endothelial cell image analysis of patients undergoing descemet membrane endothelial keratoplasty surgery

Objectives In this study, we developed a machine learning approach for postoperative corneal endothelial cell images of patients who underwent Descemet's membrane keratoplasty (DMEK). Methods An AlexNet model is proposed and validated throughout the study for endothelial cell segmentation and cell location determination. The 506 images of postoperative corneal endothelial cells were analyzed. Endothelial cell detection, segmentation, and determining of its polygonal structure were identified. The proposed model is based on the training of an R-CNN to locate endothelial cells. Next, by determining the ridges separating adjacent cells, the density and hexagonality rates of DMEK patients are calculated. Results The proposed method reached accuracy and F1 score rates of 86.15 % and 0.857, respectively, which indicates that it can reliably replace the manual detection of cells in vivo confocal microscopy (IVCM). The AUC score of 0.764 from the proposed segmentation method suggests a satisfactory outcome. Conclusions A model focused on segmenting endothelial cells can be employed to assess the health of the endothelium in DMEK patients.