Corneal volume was significantly decreased in keratoconus, particularly in the central and paracentral area. The decrease in corneal volume in moderate and severe keratoconus as detected by the Pentacam tomographer, may be explained by loss of corneal tissue. In the early stages of the disease, the altered metabolic activity may cause tissue stretching and, as the disease progresses, this stretching is then accompanied by tissue loss.
Two weeks cessation of SCL wear appears sufficient for resolution of corneal curvature changes with modern SCL materials and years of SCL wear. However, further studies with longer lens deprivation periods are required to ensure stability for all SCL wearing patients.
Corneal confocal microscopy proved to be a useful in vivo technique for assessing corneal nerve structure in this patient with keratoconus. Although the total number of stromal nerve fiber bundles was reduced in the patient with keratoconus versus the control subject, the increased tortuosity and increased nerve fiber diameter may explain why the corneal nerves appear more visible in this patient with keratoconus.
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