Confocal microscopic observations of the human cornea following overnight contact lens wear

Efron, Nathan; Mutalib, Haliza Abdul; Perez-Gomez, Inma; Koh, Hui Hiang

doi:10.1111/j.1444-0938.2002.tb03027.x

Cited by 59 publications

(45 citation statements)

References 7 publications

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“…It is important to note that due to the fact that corneal edema causes a volumetric tissue expansion and a loss of optical clarity, this may lead to an apparent loss of keratocytes, and thus the keratocyte density in FECD patients could be up to 10% higher than reported. 21 The most significant findings of this study were the profound diminishment in total number of nerves, main nerve trunks, and the total nerve length in FECD patients. Similarly, Mustonen et al have previously reported a qualitative decrease of nerves in 8 of 17 eyes.…”

Section: Discussionmentioning

confidence: 87%

Cellular and subbasal nerve alterations in early stage Fuchs’ endothelial corneal dystrophy: an in vivo confocal microscopy study

Schrems-Hoesl

Schrems

Cruzat

et al. 2012

Eye

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Purpose To analyze the morphology and density of corneal epithelial cells, keratocytes, and subbasal nerves, in patients with early stage Fuchs' endothelial corneal dystrophy (FECD) by in vivo confocal microscopy (IVCM). Methods IVCM (Confoscan 4, Nidek, Inc.) of the central cornea was performed in 30 corneas of 30 patients with early stage FECD and 13 corneas of 13 normal controls. Images were analyzed for morphology and density of the superficial and basal epithelial cells, keratocyte density, endothelial cell density (ECD), as well as subbasal corneal nerve parameters. Central corneal thickness (CCT) was measured in all patients and normals by ultrasound pachymetry. Results The ECD was significantly lower ( À 45.5%, Po0.001) in FECD patients as compared with controls. Total number of nerves and main nerve trunks were significantly reduced ( À 46.3%, Po0.001; À 39.7%, Po0.001) in patients with FECD. Posterior keratocyte density was significantly higher in FECD patients (Po0.001). Significant inverse correlations were found between CCT and total number of nerves (r ¼ À 0.69, Po0.001), CCT and main nerve trunks ( À 0.47, P ¼ 0.016), as well as CCT and total nerve length (r ¼ À 0.62, P ¼ 0.006). Significant correlation was found between ECD and total number of nerves (r ¼ 0.44, P ¼ 0.012) as well as between ECD and main nerve trunks (r ¼ 0.65, Po0.001). Conclusions IVCM demonstrates alterations in corneal innervation in patients with early stage FECD, suggesting a potential role of corneal nerves in the pathogenesis of FECD. Additional studies are required to investigate whether subbasal nerve alterations are caused by nonspecific corneal edema, from FECDinduced decrease in ECD, or potentially leading to loss of endothelial cells.

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Section: Discussionmentioning

confidence: 87%

Cellular and subbasal nerve alterations in early stage Fuchs’ endothelial corneal dystrophy: an in vivo confocal microscopy study

Schrems-Hoesl

Schrems

Cruzat

et al. 2012

Eye

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“…A semi-automated method was used to analyse the stromal keratocyte. The keratocyte nuclei were marked manually using the 'L' method to calculate the cell area and density (6,10). The fully automated method was used to analyse the endothelium.…”

Section: Confocal Microscopymentioning

confidence: 99%

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

Ghosh¹,

Mutalib²,

Kaur³

et al. 2017

MJMS

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Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope.Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively.Results: The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus.Conclusion: Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.

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“…In a recent study, stromal microdots were reported to be related to contact lens wear time and the authors stressed a hypoxia-induced mechanism [25]. In contrast, Efron and Mutalib [26] found microdots in corneas of non-contact lens wearers. In this study, 39.4% of contact lens-wearing patients revealed stromal microdots, whereas no microdots were evident in the control group.…”

Section: Discussionmentioning

confidence: 93%

In vivo confocal microscopy: corneal changes of hydrogel contact lens wearers

Yaǵmur

Okay²,

Ünal

et al. 2011

Int Ophthalmol

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To evaluate the corneal findings in hydrogel contact lens wearers by in vivo confocal scanning microscopy. One hundred and forty-two eyes of 71 myopic contact lens wearers (group 1) and 142 eyes of 71 non-contact lens wearers (group 2), whose age, gender and refractive error matched, were enrolled in order to detect the corneal changes by in vivo confocal microscopy through the central cornea. The average age was 25.5 ± 5.7 (16-52) and 25.6 ± 5.6 (17-49) in groups 1 and 2, respectively. The mean duration of contact lens wear was 43.9 ± 15.3 (6-240) months. Anterior keratocyte density was 667.5 ± 128.3 cells/mm(2) in group 1 and 821.4 ± 136.7 cells/mm(2) in group 2 (P = 0.001). Posterior keratocyte densities of groups 1 and 2 were 540.2 ± 87.6 cells/mm(2) and 628.2 ± 72.4 cells/mm(2), respectively (P < 0.001). Endothelial cellular density was 2611.2 ± 298.4 cells/mm(2) in group 1 and 2643 ± 218.2 cells/mm(2) in group 2 (P = 0.52). Ratio of polymegethism was 44.6 ± 8.8% in group 1 and 31.3 ± 4.7% in group 2 (P < 0.001). Epithelial cellular enlargement was observed in eyes wearing contact lenses with a mean Dk/t ratio of 26.5 × 10(-9) ± 5.9 (8.9-32 × 10(-9)). Stromal microdots occurred with contact lenses with a mean Dk/t ratio of 13.2 × 10(-9) ± 17.5 × 10(-9) (8.9-20 × 10(-9)). In vivo examination of the cornea with confocal microscopy revealed a number of changes. These changes can be attributed both to the mechanical and the hypoxic effects of soft contact lenses. In soft contact lenses with a high Dk/t ratio, these changes would be less frequent.

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Confocal microscopic observations of the human cornea following overnight contact lens wear

Cited by 59 publications

References 7 publications

Cellular and subbasal nerve alterations in early stage Fuchs’ endothelial corneal dystrophy: an in vivo confocal microscopy study

Cellular and subbasal nerve alterations in early stage Fuchs’ endothelial corneal dystrophy: an in vivo confocal microscopy study

Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation

In vivo confocal microscopy: corneal changes of hydrogel contact lens wearers

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