Purpose: The aim of the study was in-real time observation and morphological evaluation of the transplanted human corneas, using confocal 2.0 microscopy.
Methods: Twelve eyes of 12 patients on 3-7 days after lamellar keratoplasty (LKP), 8 eyes of 8 patients at 1 year after LKP, and 10 eyes of 10 patients at 3-7 days after penetrating keratoplasty (PKP), 11 eyes of 11 patients at 1 year after PKP were examined by confocal 2.0 microscopy in vivo. Images were recorded by continuously focusing the optical section through the full thickness central cornea.
Results: 3-7 days after LKP, small stromal cells, cranny-like dark strias and nerves were seen in transplanted corneas. There were highly reflective regions and dots in the lamellar interface. One year after LKP, the nerves disappeared. There were less highly reflective regions, but the dots still can be seen. Some gross dark strias were seen in the posterior stroma and the density of the endothelium cells was normal. 3-7 days after PKP, keratocytes were activated. Nerves and gross dark strias could be seen in transplanted corneas. The density of the endothelium cells was normal, with some highly reflective dots deposited among them. One year after PKP, the nerves disappeared, and strias still existed. The density of the endothelium cells decreased significantly.
Conclusions: Confocal scanning microscopy is a new tool for the study of cellular morphology and construction of transplanted human corneas. It can be used in the evaluation of operation effect, clinical observation and follow-up.