Abstract
Purpose: :
To observe the endothelial cells behavior in patients with intrastromal corneal ring segments of 0.450 in thickness.
Methods: :
This is a prospective, longitudinal, and observational study. Patients with keratoconus who underwent surgical implantation of intrastromal corneal ring segments (INTACS) were included. Endothelial cell images were collected preoperative and at 1, 2 and 3 months after surgery. Non–contact specular microscopy (Topcon SP. 2000 P) was done at the central and peripheral (temporal area) cornea , a predetermine value of 25 cells was used to calculate density. Also a contact confocal microscopy, manual count (50 cells with Confoscan 3, Nidek) was done, images were recorded and analyzed. Cell density, hexagonal cells percentage, and polimegatism were determined. Central Tendency was determined and analysis of variance between groups were done.
Results: :
Fifteen eyes of 11 patients, 6 male, 5 female were included. Mean age was 30 years old. One hundred and twelve confocal images and 96 especular images were studied. There was in the central cornea with both specular and confocal microscopy, a reduction in cell density of 6.8% (191.32 cells) and 4.5% (128.5 cells) respectively (p < 0.05). In peripheral cornea endothelial cell density decreased 13.4% (398.82 cells) by specular microscopy. (p<0.05) Mean preoperative polymegatism was 47.5% and 42.3 postoperatively (p > 0.05). Mean preoperative pleomorphism was 41.7% and 44.5% postoperatively (p > 0.05).
Conclusions: :
Intrastromal corneal ring segments of 0.450 in thickness are not innocuous and may affect corneal endothelium structure at third month of implantation in patients with keratoconus.
Keywords: cornea: endothelium • imaging/image analysis: clinical • keratoconus