Early confocal microscopy findings after cross-linking treatment

Area of Science:

• Ophthalmology
• Corneal Science
• Biomedical Engineering

Background:

• Keratoconus is a progressive corneal ectasia.
• Corneal cross-linking (CXL) aims to strengthen the cornea.
• Understanding CXL's in vivo effects is crucial for treatment optimization.

Purpose of the Study:

• To evaluate the in vivo effects of corneal cross-linking treatment.
• To assess changes in corneal stromal depth and cellular activity post-CXL.

Main Methods:

• Corneal cross-linking performed on 18 eyes using riboflavin and UVA radiation.
• In vivo confocal microscopy used for imaging before and after treatment (1 week, 1 month).

Main Results:

• Keratocyte activation and collagen fiber organization observed as hyper-reflective structures.
• Changes noted from the sub-epithelial layer to stromal depths of 275.1 ± 85.9 μm at 1 week.
• At 1 month, changes extended to 324.9 ± 66.0 μm, with deeper linear hyper-reflective structures.

Conclusions:

• In vivo confocal microscopy revealed corneal stromal changes following CXL treatment in humans.
• These changes, including cellular activation and fiber organization, occurred at depths exceeding 300 μm in some cases.