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In vivo pachymetry and morphological evaluation with CS4 corneal confocal microscopy after femtosecond laser and microkeratome-assisted endothelial keratoplasty

Poster Details

First Author: L.Mosca ITALY

Co Author(s):    R. Fasciani   L. Mosca   L. Guccione   M. Toro   R. Secondi   E. Balestrazzi

Abstract Details


To evaluate in vivo confocal microscopic and pachymetry features seen in patients that underwent to DSAEK and to DSEK assisted with femtosecond laser (Femto-DSEK).


Ophthalmic Department, Catholic University of “Sacro Cuore”, “A. Gemelli” Polyclinic, Rome, Italy


23 eyes of 20 patients submitted to 13 DSAEK and 10 Femto-DSEK were evaluated using CS4 confocal microscopy. Using 40x lens and Z-ring device of CS4, a morphological evaluation of interface and stromal and endothelial tissue trophism and a pachimetry study of ablation and residual bed thicknesses were performed at 1 month and 1 year after surgery.


No endothelial cell density difference was seen between DSAEK and Femto-DSEK procedures. At 1 month, oedema produced increase of set donor endothelial lamella and donor- recipient interface haze thickness, evident stromal folds and scattering with low keratocites evidence in both techniques. These features progressively improved at 1 year of follow-up. In 4 cases (2 DSAEK and 2 FemtoDSEK), despite of a good endothelial density and of the reduction of stromal oedema, the persistence of an hyporeflective band above the endothelium and of an high hypereflectivity in the lamellar interface produced bad visual recovery.


Confocal microscopy seems to be a useful procedure to investigate in vivo the results of keratoplastic surgery. The morphological and pachimetry analysis of the tissues permits a direct evaluation and comparison between the different keratoplasty techniques.

Financial Disclosure:


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