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W. Zhu; In vivo Confocal Microscopy Analysis of the Ocular Surface in Patients With Severe Chemical Burns. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5663.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate dynamic changes of ocular surface after severe chemical burns by in vivo confocal microscopy (CM).
45 patients (61 eyes) suffering from severe chemical burns were enrolled in the study and divided into 4 groups according to the course of disease: A (within 3 months post burn), B (3~6 months), C (6~12months) and D (over 12 months). CM was performed on the central cornea, the inferior limbus and the inferior bulbar conjunctiva of the injured eye and the typical images were analyzed.
The positive rates of corneal epithelial conjunctivalization were 5%, 41.7%, 50%, 91.7% and the positive rates of corneal stromal fibrosis were 16.7%, 21.2%, 66.7%, 91.7%, both showing a substantial increasing correlation with the course(P=0.000). Goblet cells were observed on the cornea and the corneal endothelium was distinguishable. The limbal Vogt Palisades were destroyed in all groups. The densities of inflammatory cells in the limbus were 3972±347 cells/mm2, 2988±437 cells/mm2, 2673±403 cells/mm2, 2647±284 cells/mm2, with a significant reduction(P=0.000). The densities of dendritic cells in the limbus were 106±20 cells/mm2, 139±37 cells/mm2, 140±24 cells/mm2, 91±27 cells/mm2, with a significant reduction(P=0.000). Inflammatory cells in conjunctival epithelium and neovascularization in conjunctival lamina propria decreased significantly with the course of the disease. Accoding to the Least Significant Difference analysis, the inflammatory cells on the ocular surface maintained stable after one year after burns.
CM analysis indicated that the micromorphology of the ocular surface changes with time after severe chemical burns, which were helpful to identify the proper type and better opportunity of operations.
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