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Updated: Aug 8, 2026
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Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
A longitudinal case series investigating cellular changes to the transplanted cornea using confocal microscopy
Joanna G Hollingsworth1, Nathan Efron, Andrew B Tullo
1Eurolens Research, Moffat Building, The University of Manchester, PO Box 88, Manchester M60 1QD, UK.
Summary
Penetrating keratoplasty recovery shows slow epithelial healing and delayed nerve regeneration over 12 months. In vivo confocal microscopy reveals changes in corneal cells and haze post-transplant.
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- Penetrating keratoplasty (PK) is a common corneal transplant procedure.
- Understanding the in vivo cellular changes post-PK is crucial for optimizing patient recovery and visual outcomes.
Purpose of the Study:
- To longitudinally evaluate corneal morphology after penetrating keratoplasty using in vivo confocal microscopy.
- To compare the recovery of corneal structures and cellular components in transplanted corneas to normal controls over a 12-month period.
Main Methods:
- In vivo slit scanning confocal microscopy was employed to examine the central cornea of four subjects post-PK.
- Subjects underwent four examinations over 12 months, with quantitative and qualitative data analyzed.
- Corneal morphology was compared to age-matched normal control subjects.
Main Results:
- Epithelial healing varied, taking up to 12 months to resemble normal corneal structure.
- Bowman's layer showed initial absence of nerve fibers, with regeneration observed at 12 months.
- Stromal nerves were initially absent but became visible as thin, straight structures by 1 year.
- Keratocyte density remained low but constant, with activated keratocytes contributing to corneal haze.
- Endothelial cell density showed an accelerated decrease over the study period.
Conclusions:
- In vivo confocal microscopy is effective for monitoring cellular changes after penetrating keratoplasty.
- The study highlights the prolonged and variable nature of corneal recovery post-transplant.
- Findings may aid clinicians in understanding and managing postoperative recovery in PK patients.
