Long-term Follow-up of Penetrating Keratoplasty Patients with In-vivo Confocal Corneal Microscopy
Imre L., Resch M., Nagymihály A.
1st Department of Ophthalmology, Semmelweis University, Budapest/H
Purpose: 25 eyes with clear grafts after penetrating keratoplasty were examined with in vivo confocal corneal microscopy in 1999. Mean follow-up time of patients was 22 months. 50 months later (72 months postoperatively) confocal corneal microscopy was repeated. Our aim was the investigation and the comparison of the changes of clear corneal grafts 22 and 72 months postoperatively.
Method: 7 eyes could be involved in the 72 months study (3 patients died, 6 disappeared, 7 had repeated keratoplasty and 2 patients did not show up). The mean age of patients were 59.9±20.1 years. With confocal microscopy (Tomey P4 slit scanning type) the epithelium, the regeneration of nerves, keratocytes of the anterior and posterior stroma and the endothelium were evaluated.
Results: Mean best spectacle corrected visual acuity was 0,42±0,34. Superficial epithelial cells contained nucleus in all eyes. Mean density of basal epithelial cells was 3896±542 cells/mm2 at 22 months and 3200±642 cells/mm2 at 72 months postoperatively. Nerve fibers were observed in the Bowman membrane and the anterior stroma in each case, often with irregular course. At 22 months the keratocyte density was 750±82 cells/mm2 in the anterior stroma and 604±78 cells/mm2 in the posterior stroma, at 72 months 383±52 cells/mm2 in the
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