[Observation on healing process of corneal lens after epikeratophakia with confocal microscopy]

To investigate the nerve and cell healing process of cryopreservation tissue lens after epikeratophakia by in vivo confocal microscopy.

Epithelia, stroma and nerves of tissue lens, interface between lens and recipient and stroma and endothelia of recipient were observed by in vivo confocal microscopy and recorded by video in 24 cases of keratoconus from 3 days to 5 years after epikeratophakia.

Epithelial layer of lens: The tissue lens was covered by corneal superficial flat cells with wing cells and basal cells on the periphery at 3 - 4 days postoperatively, but the morphology and arrangement of these cells were irregular with low density. Superficial flat cells took shape completely at one month, and the morphology and density of the basal cells tended to be normal at 6 months postoperatively. Subepithelial nerve plexus were scattered at 18 months and their normalization completed at 2 years postoperatively. Stroma of lens: Keratocytes appeared circular, dot-shaped, rod-shaped or reticular in morphology postoperatively. Normal keratocytes were discovered sporadically on the periphery of the lens at 2 years postoperatively. At 5 years postoperatively the density of keratocytes was lower than normal stromal keratocyte in the center of the lens. Stromal nerves of lens: Nerves could grow into tissue lens at 6 months postoperatively, the quantity of nerves increased at 2 years and was still less than normal quantity at 5 years postoperatively. Stroma and endothelia of recipient: There was no change in the stroma and endothelia of recipient.

There is significant difference among healing process of epithelia, nerves of unvital tissue lens after epikeratophakia, but there is little change in the transparency of tissue lens.