Confocal microscopy of corneal wound healing after Ho:YAG laser thermokeratoplasty.

摘要

PURPOSE: To investigate corneal wound healing using confocal microscopy in patients who underwent laser thermokeratoplasty (LTK) for hyperopia between +1.50 and +3.00 diopters (D). METHODS: In a prospective, nonrandomized study, 78 eyes of 42 patients were followed for 1 year using contact and non-contact confocal microscopy to evaluate corneal appearance after LTK with the Oko-1 Ho: YAG laser. The NIDEK Confoscan 4, 20x non-contact lens and 40x contact lens, was used to evaluate the morphology of the corneal layers. The Oko-1 laser was used to reduce or eliminate hyperopic refractive error. Patients underwent confocal microscopy measurement preoperatively, 1 and 2 weeks and 1, 3, 6, and 12 months after LTK. Individual examinations were reviewed and classified by the investigators. RESULTS: Preoperatively, spherical hyperopia was +2.11 +/- 0.21 D (range: +1.50 to +2.75 D). At 3 months postoperatively, the mean manifest refractive spherical equivalent (MRSE) was +0.11 +/- 0.02 D and +0.21 +/- 0.02 D at 1 year. Mean corneal pachymetry was 631.6 +/- 8.40 microm preoperatively, 637.4 +/- 12.7 microm at 3 months, and 608.4 +/- 31.7 microm at 1 year. The mean endothelial cell density was 2771.4 +/- 28.4 cells/mm2 preoperatively, 2709.4 +/- 122.3 cells/mm2 at 3 months, and 2693.2 +/- 139.1 cells/mm2 at 1 year. Activated keratocytes were present at 3 months postoperatively, which decreased over the course of 1 year. CONCLUSIONS: Laser thermokeratoplasty for low to moderate hyperopia using the Oko-1 results in formation of intrastromal fibrosis with minimal changes in corneal morphology outside the sites of treatment.