scholarly journals Evaluation of Corneal Nerves and Dendritic Cells By in Vivo Confocal Microscopy After Descemet’s Membrane Keratoplasty For Bullous Keratopathy

Author(s):  
Takahiko Hayashi ◽  
Atsuyuki Ishida ◽  
Akira Kobayashi ◽  
Takefumi Yamaguchi ◽  
Nobuhisa Mizuki ◽  
...  

Abstract This study evaluated changes in corneal nerves and the number of dendritic cells (DCs) in corneal basal epithelium following Descemet membrane endothelial keratoplasty (DMEK) surgery for bullous keratopathy (BK). Twenty-three eyes from 16 consecutive patients that underwent DMEK for BK were included. Eyes of age-matched patients that underwent pre-cataract surgery (12 eyes) were used as controls. In vivo confocal microscopy was performed pre- and postoperatively at 6, 12, and 24 months. Corneal nerve length, corneal nerve trunks, number of branches, and the number of DCs were determined. The total corneal nerve length of 1634.7 ± 1389.1 μm /mm2 before surgery was significantly increased in a time-dependent manner to 4485.8 ± 1403.7 μm /mm2, 6949.5 ± 1477.1 μm /mm2, and 9389.2 ± 2302.2 μm /mm2 at 6, 12, and 24 months after DMEK surgery, respectively. The DC density in BK cornea pre- and postoperatively at 6 months was significantly higher than in the controls, and decreased postoperatively at 12 and 24 months and was significantly lower than that at 6 months postoperatively. Thus, our results suggest that DMEK can repair and normalize the corneal environment.

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Dai Wang ◽  
Peng Song ◽  
Shuting Wang ◽  
Dapeng Sun ◽  
Yuexin Wang ◽  
...  

Purpose.To evaluate the changes of keratocytes and dendritic cells in the central clear graft by laser scanning in vivo confocal microscopy after penetrating keratoplasty (PK).Methods.Thirty adult subjects receiving PK at Shandong Eye Institute and with clear grafts and no sign of immune rejection after surgery were recruited into this study, and 10 healthy adults were controls. The keratocytes and dendritic cells in the central graft were evaluated by laser scanning confocal microscopy, as well as epithelium cells, keratocytes, corneal endothelium cells, and corneal nerves (especially subepithelial plexus nerves).Results.Median density of subepithelial plexus nerves, keratocyte density in each layer of the stroma, and density of corneal endothelium cells were all lower in clear grafts than in controls. The dendritic cells of five (16.7%) patients were active in Bowman’s membrane and stromal membrane of the graft after PK.Conclusions.Activated dendritic cells and Langerhans cells could be detected in some of the clear grafts, which indicated that the subclinical stress of immune reaction took part in the chronic injury of the clear graft after PK, even when there was no clinical rejection episode.


2021 ◽  
pp. bjophthalmol-2020-318156
Author(s):  
Holly Rose Chinnery ◽  
Rajni Rajan ◽  
Haihan Jiao ◽  
Mengliang Wu ◽  
Alexis Ceecee Zhang ◽  
...  

Background/aimsThis systematic review critically evaluated peer-reviewed publications describing morphological features consistent with, or using terms related to, a ‘neuroma’ or ‘microneuroma’ in the human cornea using laser-scanning in vivo confocal microscopy (IVCM).MethodsThe review was prospectively registered on PROSPERO (CRD42020160038). Comprehensive literature searches were performed in Ovid MEDLINE, Ovid Embase and the Cochrane Library in November 2019. The review included primary research studies and reviews that described laser-scanning IVCM for examining human corneal nerves. Papers had to include at least one of a pre-specified set of keyword stems, broadly related to neuromas and microneuromas, to describe a corneal nerve feature.ResultsTwenty-five papers (20 original studies; 5 reviews) were eligible. Three original studies evaluated corneal nerve features in healthy eyes. Most papers assessed corneal nerves in ocular and systemic conditions; seven studies did not include a control/comparator group. There was overlap in terminology used to describe nerve features in healthy and diseased corneas (eg, bulb-like/bulbous, penetration, end/s/ing). Inspection of IVCM images within the papers revealed that features termed ‘neuromas’ and ‘microneuromas’ could potentially be physiological corneal stromal-epithelial nerve penetration sites. We identified inconsistent definitions for terms, and limitations in IVCM image acquisition, sampling and/or reporting that may introduce bias and lead to inaccurate representation of physiological nerve characteristics as pathological.ConclusionThese findings identify a need for consistent nomenclature and definitions, and rigorous IVCM scanning and analysis protocols to clarify the prevalence of physiological, as opposed to pathological, corneal nerve features.


2020 ◽  
pp. bjophthalmol-2019-315449 ◽  
Author(s):  
Giuseppe Giannaccare ◽  
Federico Bernabei ◽  
Marco Pellegrini ◽  
Fabio Guaraldi ◽  
Federica Turchi ◽  
...  

AimsTo evaluate bilateral morphometric changes of corneal sub-basal nerve plexus (CSNP) occurring after unilateral cataract surgery by in vivo confocal microscopy (IVCM) images analysed with automated software.MethodsIVCM was performed before (V0) and 1 month after surgery (V1) in both operated eyes (OEs) and unoperated eyes (UEs) of 30 patients. Thirty age and sex-matched subjects acted as controls. Corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), corneal nerve fibre length (CNFL), corneal nerve total branch density (CTBD), corneal nerve fibre area (CNFA), corneal nerve fibre width, corneal nerve fractal dimension (CNFrD) and dendritic cells density were calculated.ResultsMean CNFD, CNBD, CNFL, CTBD, CNFA and CNFrD significantly decreased at V1 versus V0 in both eyes (respectively, 15.35±7.00 vs 21.21±6.56 n/mm2 in OEs and 20.11±6.69 vs 23.20±7.26 in UEs; 13.57±12.16 vs 26.79±16.91 n/mm2 in OEs and 24.28±14.88 vs 29.76±15.25 in UEs; 9.67±3.44 mm/mm2 vs 13.49±3.42 in OEs and 12.53±3.60 vs 14.02±3.82 in UEs; 22.81±18.77 vs 42.25±24.64 n/mm2 in OEs and 38.06±20.52 vs 43.93±22.27 in UEs; 0.0040±0.0021 vs 0.0058±0.0020 mm2/mm2 in OEs and 0.0049±0.0016 vs 0.0057±0.0019 in UEs; 1.418±0.058 vs 1.470±0.037 in OEs and 1.466±0.040 vs 1.477±0.036 in UEs; always p<0.049).ConclusionPatients undergoing cataract surgery exhibit bilateral alterations of CSNP. This finding could have broad implications in the setting of sequential cataract surgery.


Cornea ◽  
2000 ◽  
Vol 19 (Supplement 2) ◽  
pp. S131
Author(s):  
T Tervo ◽  
T U Valle ◽  
J AO Moilanen ◽  
M E Rosenberg ◽  
I SJ Tuominen ◽  
...  

Cornea ◽  
2013 ◽  
Vol 32 (10) ◽  
pp. 1331-1338 ◽  
Author(s):  
Gene Kim ◽  
J. Robinson Singleton ◽  
Mark D. Mifflin ◽  
Kathleen B. Digre ◽  
Michael T. Porzio ◽  
...  

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