Purchase this article with an account.
C. Weenen, B.T. H. van Dooren, K.R. M. Herman, J. van Rooij, H. van Cleynenbreugel, L. Remeijer; In Vivo Confocal Microscopy Of The Interface In Lamellar Surgery Of The Cornea . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1353.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe differences in morphology and light intensity of the interface of the cornea after lamellar surgery, investigated by in vivo confocal microscopy. Patients underwent Deep Anterior Lamellar Keratoplasty (DALK), Posterior Lamellar Keratoplasty (PLK) or Free Hand Lamellar Keratoplasty (FHLK).
Thirteen eyes from 13 patients were operated in the Rotterdam Eye Hospital between 1998 and 2000 by one of three surgeons. Five patients underwent a DALK, 5 patients a PLK and 3 patients an FHLK. In 2004 all patients were examined by in vivo slit scanning confocal microscopy (Nidek Confoscan 3). In all patients at least 3 scans of the cornea were suitable for investigation of the interface. The mean light intensity per photo of the interface was determined using NAVIS proprietary software.
All patients undergoing a PLK were diagnosed with Fuchs’ endothelial dystrophy. In the DALK group, 4 patients were treated for keratoconus and 1 patient for a quiescent Herpes Simplex stromal scar, while in the FHLK group all patients were treated for keratoconus. The mean light intensity in the DALK group was 84,8 (60.4–107.1), in the PLK group 69.1 (43.0–105.6) and in the FHLK group 80.2 (61.2–104.2). Higher reflectivity of the interface was caused by debris or by changes in the matrix and keratocyte morphology. There is a difference in mean light intensity between patients, while the intrapatient variability was low. In one case, however, one scan showed highly reflective debris in the interface, while this was not seen in other pictures.
In vivo confocal microscopy is a good tool to depict and compare the interface of the cornea after lamellar surgery.
This PDF is available to Subscribers Only