Abstract
Purpose:
To describe corneal density image behavior in patients who underwent penetrating keratoplasty(PK) with a slit illumination system and a scheimpflug camera device.
Methods:
: Prospective, longitudinal, descriptive study which included patients who underwent uneventful PK with different noninflammatory diagnoses. Corneal density was measured with Pentacam (Oculus, Pentacam HR, UG70700/0712/en, Madrid, España) postoperatively at week one and each month for a 6 month period. For study purposes the cornea was divided in depth into three thirds: A. Anterior 120 μm; B. middle layer; C. Posterior 60 μm. Also, we divided the zones according to topoghraphic place in: central cornea (0-2 mm) and paracentral cornea (2-6 mm). One image was taken for each zone and the density value provided by the Pentacam software was noted.
Results:
13 eyes of 13 patients were included, with the following diagnoses: 9 patients with keratoconus, 3 with bullous keratopathy, and 1 corneal scar. Patients age was 35.6 ±18.7 years and donor cornea age was 30.6±18.9 years. The central (0-2mm) corneal densities obtained were 25.2 ±5.17 at the first week, 21.2±4.56 at the first month and 19.2 ±2.98 at the third month. The paracentral (2-6mm) corneal densities obtained were 26.5 ± 7.01 at the first week, 23.3 ±3.53 at the first month and 24.2 ±3.46 at the third month. Regarding depth, the obtained densities were: A. Anterior: first week 38.1 ±13.3; first month 33.9 ± 11.7 and third month 33.8±6.09. B. Middle: first week 22.9 ±6.56 , first month 17.9 ± 1.81, and third month 17.7 ± 1.90. C. Posterior: first week 14.8 ±4.27, first month 12.6 ± 2.03, and third month 12.8 ± 2.59. One patient had an endothelial rejection at the sixth week of follow up. The corneal densities in this case shifted as follows: central cornea from 17.1 to 35.5, paracentral cornea from 18.9 to 30.9, anterior third from 24.8 to 50.9, middle from 15.1 to 30.8 and posterior from 11.4 to 24.9.
Conclusions:
Corneal density tends to decline after PK. Corneal density was always higher in the paracentral area than in the central área. Corneal density was higher in the anterior third, than the middle third and posterior third. The density increases in corneal rejection episode.
Keywords: 481 cornea: endothelium