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Gema Olea Zorita, Jesus Fraile Maya, Aurora Ruiz Calvo, Ricardo Cuiña Sardiña, David Diaz Valle, Pedro Arriola Villalobos, Jose Manuel Benitez-del-Castillo; Cross-linking In Keratoconus: Confocal Microscopy Early Changes. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4204.
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Confocal microscopy allows an in vivo ultrastructural analysis of the cornea. The purpose of this study is to evaluate keratoconic corneas after cross-linking using confocal microscopy in the early postoperative period.
After the application of a topical anesthesia, mechanical scraping of the epithelium was performed. The cornea was then soaked in rivoflavin solution 0.1% (Ricrolin, Italy) every 2.5 minutes for 30 minutes and afterwards exposed to UVA radiation (3mW/cm2) for 30 minutes. Corneas were examined before and one, two, four, twelve and twenty-four weeks after cross-linking. Five keratoconic corneas were treated and studied using the Heidelberg HRT II with Rostock module.
An increase in epithelial stratification was observed and all the epithelial cells appeared nucleated one week after treatment. Anterior stroma keratocytes were activated. A neat delimitation line between the middle stroma and the posterior stroma was observed. The endothelium was normal. Epithelial cells started to normalize two weeks after the treatment. However, intra and subepithelial nerves were not present until the third month, when stromal fibrosis appeared.
Confocal microscopy is a useful technique in the evaluation of ultrastructural changes after corneal cross-linking.
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