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System of objective evaluation of postsurgical histomorphological changes in cornea

Poster Details

First Author: V.Fokin RUSSIA

Co Author(s):    H. Solodkova   I. Melikhova           

Abstract Details



Purpose:

To develop, basing on findings of confocal microscopy, qualitative characteristics for analysis of histomorphological changes occurring in cornea after different kinds of surgical treatment

Setting:

The S.N. Fyodorov Eye Microsurgery Federal State Institution, Volgograd branch

Methods:

there were evaluated results of treatment performed in 61 patients (61 eyes) with keratoconus of the I-II degree in comparison to results of LASIK in 105 patients (210 eyes) with various degree of myopia and results of PRK in 50 patients (100 eyes) with low and moderate myopia. Prior to and 1, 3, 6 and 12 months after the operation all patients underwent an extensive examination including confocal microscopy with endothelial cell count (Confoscan4, Nidek, Japan).

Results:

there was proposed a 4-point score system. Degree of manifestation of stromal edema was defined as follows: 0 points - insignificant decrease of transparency, 1 point - moderate degree of edema, involving epithelium, Bowman's membrane, anterior stroma, moderate transparency decrease; 2 points - corneal edema reaches medium stroma and is accompanied with an expressed transparency aggravation, 3 points - an expressed stromal edema affecting Descemet's membrane and significant decrease of transparency. Condition of epithelial layer was evaluated both in basal and aliform cells: 0 points - no alterations, 1 point - sporadic defects in superficial layer, a feeble pseudokeratinization of aliform cells, 2 points - multiple defects, a marked pseudokeratinization, a small number of epitheliocytes with modified hyperreflective nuclei in basal layer; 3 points - an increased number of modified epithelial cells. Alteration of stromal cell structure was gaged by the number of active keratocytes with prominent hyperreflective nuclei in the field of view (0,2×0,15 mm) - 0 points - absence of the described cells, 1 point - 10 cells and less, 2 points - from 10 to 30 cells, 3 points - more than 30 keratocytes. Density of endothelial cells remained unchanged in all the cases.

Conclusions:

the proposed system of histomorphological change analysis provides an objective status evaluation for all the corneal structures and estimation of treatment effectiveness. FINANCIAL INTEREST: NONE

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