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Updated: Apr 5, 2026
Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
Predicting Corneal Graft Rejection by Confocal Microscopy.
Viridiana Kocaba1, Caterina Colica, Muriel Rabilloud
1*Department of Ophthalmology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France; †Université de Lyon, Lyon, France; ‡Hospices Civils de Lyon, Eye Bank, Edouard Herriot Hospital, Lyon, France; §Policlinico Umberto I Hospital, "Sapienza" University of Rome, Italy; ¶Université Lyon 1, Villeurbanne, France; ‖Hospices Civils de Lyon, Service de Biostatistique, Lyon, France; and **CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France.
Activated keratocyte (AK) counting using in vivo confocal microscopy can predict corneal graft rejection. Increased AK counts signal subclinical rejection up to two months before clinical diagnosis in patients undergoing keratoplasty.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Transplantation Immunology
Background:
- Corneal transplantation, or keratoplasty (PK), is a common procedure to restore vision.
- Monitoring corneal graft health and predicting rejection are critical for successful outcomes.
- Activated keratocytes (AKs) play a role in corneal wound healing and immune responses.
Purpose of the Study:
- To evaluate the utility of activated keratocyte (AK) counting via in vivo confocal microscopy for assessing corneal healing post-perforating keratoplasty (PK).
- To determine if AK counting can predict corneal graft rejection.
- To identify AK count as a potential early biomarker for subclinical rejection.
Main Methods:
- Prospective observational study of 45 patients undergoing PK.
- In vivo confocal microscopy used for monitoring at specified intervals (day 1, day 7, monthly).
- AKs quantified in stromal layers; counts compared between patients with and without rejection.
Main Results:
- AK counts significantly increased in patients who later experienced graft rejection, starting two months prior to clinical diagnosis.
- AK counts remained stable in patients without rejection.
- AK counts peaked at rejection diagnosis and decreased post-treatment.
Conclusions:
- AK counting is a valuable tool for predicting corneal graft rejection after PK.
- Elevated AK counts can serve as an early indicator of subclinical rejection, preceding clinical signs by up to two months.
- This method offers a non-invasive approach to monitor graft status and guide treatment decisions.
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