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S. C. Kaufman, J. Dhaliwal; A Confocal Microscopic Study of Corneal Collagen Crosslinking. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1853.
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Corneal collagen crosslinking has been proposed as a treatment for keratoconus and other types of corneal ectasias. The purpose of this study is to describe the changes in morphology after corneal collagen crosslinking, as observed by confocal microscopy.
Three corneas, obtained from the Midwest Eye Bank, were examined initially by white-light confocal microscopy. The central epithelium was removed from the 3 corneas. The corneas were then treated with a riboflavin 0.1% solution, every 2 minutes for 30 minutes, while the corneas were exposed to 370 nm UVA light at an intensity of 3 mw/cm2. The corneas were then reexamined by confocal microscopy. The images were recorded and compared to the pretreatment images of the corneas.
The 3 corneas appeared normal on their initial, pretreatment examination with reduced stromal detail. After treatment, the corneas demonstrated a superficial layer of highly reflective, spherical objects that appeared to be approximately 10 microns in diameter. A small number of these hyper-reflective spheres also appeared within the stroma of the corneas - up to a depth of 100 microns. The remainder of the corneal stroma and endothelium appeared normal.
After corneal collagen crosslinking with riboflavin and UVA, white-light confocal microscopy demonstrated hyper-reflective structures on the surface and within the anterior stroma of the corneas. Further studies are warranted concerning this promising treatment for corneal ecstatic conditions.
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