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E Hernandez-Quintela, G de Wit-Carter, M Ramirez-Fernandez, M Hernandez, S Quintero, JC de-la-Luz, R Naranjo-Tackman; Confocal Microscopy Findings In Deep Lamellar Keratoplasty . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4241.
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Purpose: To describe confocal microscopy findings in deep lamellar keratoplasty (DLK). Methods:A central scan of full-thickness cornea was performed with a confocal microscope (Confoscan, Fortune Technology, Italy) in 4 eyes (4 patients) one week after DLK. Preoperatrive diagnosis included corneal ectasia after radial keratotomy (1), actinic keratoconjunctivitis (1), and granular dystrophy (2). The surgical procedure was performed with a 7.5 mm Barron trephine until desired depth was achieved, remaining stroma was delaminated with a crescent knife to Descemet’s membrane. Early morphology cellular findings after DLK are described. Results:Confocal microscopy examination of the donor cornea revealed anterior stromal keratocytes with evident cytoplasm and an increased reflectivity at a subepithelial level. Optical sections through the donor stroma showed microplicae arranged in a reticular pattern. The donor-receptor interface showed several highly reflective round images with 10 to 50 microns of diameter, with a disperse distribution. Confocal microscopy examination was able to show the endothelial mosaic in 2 cases. Conclusion:Confocal microscopy permitted in vivo visualization of cellular morphology changes of the cornea after DLK.
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