Abstract
Introduction: :
Objective: To determine the characteristics of corneal grafts with confocal microscopy in patients after at least one year of transplant.
Materials and Methods: :
Observational, prospective, transversal design. We evaluated with Confoscan 3: endothelial cell area and density, pleomorphism, polymegathism, cell loss within time, Guttae classification; density of activated keratocytes in anterior stroma; subbasal and subepithelial nerve characteristics and epithelial cell density, and their relationship with the etiologic cause for the transplant, age and years with the corneal graft.
Results: :
We evaluated 6 eyes of patients from the department of cornea and refractive surgery in the Fundaciòn Hospital Nuestra Señora de la Luz.All patients were men, wth a mean age of 44.33 (+/- 29 years), the cause for corneal transplant was in 5 (83.33%) keratoconus and in 1 (16.66%) bullous keratopathy. In 3 patients (50%) right eye was involved. The surgery was performed 3.5 years ago (+/- 1.6)Endothelial cellular density was 1340/mm² (+/- 770); endothelial surface area was 0.0014/mm², we found 41.51% pleomorphism (+/- 22.13%), polymegatism 45% (+/- 7%). Corneal Guttae classification was grade 1 in mostly patients. Keratocyte density in anterior stroma was of 9.4/mm² cells. Epithelial cell density was of 4404/mm² cells (+/- 390)We made two groups: In group one, less than three years of the transplant, the endothelial cellular density was 1861/mm² (+/- 300) and endothelial surface area was 0.00010/mm² (+/- 0.00003)In group Two, more than three years of the transplant, endothelial cellular density was 702.69/mm² (+/- 100) and endothelial surface area was 0.00030/mm² (+/- 0.00001)We compared group one and two with Mann - Whitney test and we found a statistic significance difference in the endothelial cellular density loss P = 0.32 and in the endothelial surface area P = 0.000
Conclusions: :
Confocal microscopy is a very helpful tool for the evaluation of corneal grafts and it allows us to evaluate its characteristics through time, letting us see the evolution and in some way predict the possible future complications. We may say that throughout time endothelial cell loss and surface area is very significant.
Keywords: microscopy: confocal/tunneling • cornea: endothelium • cornea: epithelium