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A. Gutierrez, A. Ortiz, A. Higueras, C. Villa, A. Navarro, J. Merayo-Lloves; Six Months Follow-Up of Confocal Microscopy of Keratoconus Corneas Exposed to Collagen Cross-Linking With Riboflavin and Ultraviolet Light (c3cruva). Invest. Ophthalmol. Vis. Sci. 2008;49(13):4337. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze by confocal microscopy the histological changes in keratoconus corneas treated with C3CRUVA during 6 months follow up
Six eyes of three patients with bilateral keratoconus underwent C3CRUVA for 30 minutes. Preoperative measurement were mean age of 20 year old (range 18 to 26), at least 400 microns pachymetry, best corrected visual acuity from 20/100 to 20/20, keratometric cylinder from 2,03 to 5,12 diopters, and mean keratometric curvature from 40,85 to 56,36. All patients were examined with confocal microscopy before treatment one month, 3 months and six months after treatment.
Confocal microscopy images at 1 and 3 months post operative showed haze, reduction in the density of keratocytes population at anterior stroma (250-300 µm) and a strong decreasing number of subbasal nerves in the at one month and three months visit. This wound healing reaction was recovery at 6 months time point with 90% reduction of haze and 80% repopulation of anterior stroma keratocytes, but no reinnervation of basal plexus were detected. No changes were detected in posterior stroma and corneal endothelial cell density in all the follow-up. Presence of haze is associated with curvature changes.COCLUSION: C3CRUVA of keratoconus corneas promotes corneal wound healing (haze, reductions of keratocytes density and permanent nerve damage) as far as 300 microns deep with marked reduction of the scaring at 6 moths follow-up.
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