Confocal Microscopy of Fifty Year Old Corneal Transplants

Abstract

Abstract: : Purpose: To characterize the in–vivo morphology of corneal grafts fifty years after transplantation. Methods: A Nidek Confoscan III confocal microscope was used to image the corneas of a 72 year old male who underwent penetrating keratoplasty for keratoconus in 1953. Results: On slit lamp examination the grafts demonstrated stromal haze and mild scarring. Ultrasonic pachymetry measurements were 0.64mm OD and 0.5mm OS. Best corrected vision with gas permeable contact lenses was 20/30 OU. Confocal microscopy revealed endothelial pleomorphism and polymegethism, with decreased cell counts. The stromal matrix was characterized by deep folds and areas of crisscrossing linear patterns. In one graft a markedly "serpentine" nerve pattern was noted in the anterior stroma. Conclusions: To our knowledge this is the first report of confocal microscopy in fifty year old corneal grafts. Corneal nerve regeneration in one graft was markedly atypical.  

Keywords: cornea: stroma and keratocytes • imaging/image analysis: clinical • regeneration