To determine how frequently specular microscopy results affect the outcome of eye-bank judgments on the transplantability of donor corneas, 1,011 consecutive donor records from a 3-year period at the Transplant Services Center of the University of Texas Southwestern Medical Center at Dallas were analyzed. Specular microscopy cell counts from each decade of donor age were determined, and it was found that there were no cell counts < 2,000 mm2 for any donor age < 40. Above age 40, the percentage of cell counts < 2,000 per mm2 rose from 3.9% for donors in their forties of 6% for donors in their seventies. For donors between 40 and 69 years, specular microscopy was used to rule out unacceptable tissue in an additional 3.3% of a prescreened pool of corneas evaluated by current Eye Bank Association of America standards. While corneas from donors over age 69 were initially presumed to be unacceptable for transplant at this eye bank, routine specular microscopic examination helped to clear for transplant of 31 corneas from donors of this age group.