Related Experiment Video
Updated: Aug 5, 2026
Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
Stage-dependent alterations in corneal epithelium, stromal keratocyte density, and subbasal nerve plexus in
Tugce Kucukbalci1, Betul Seher Uysal2, Damla Balaban2
1Department of Ophthalmology, Gazi University School of Medicine, Ankara, 06500, Turkey. tugcekucukbalci@gmail.com.
Purpose:
The primary aim of this study was to evaluate the morphologic changes of the corneal epithelium by in vivo confocal microscopy (IVCM) in keratoconus patients according to stage, and the secondary aims were to evaluate the subbasal nerve plexus and stroma in addition to the epithelium and to examine whether there were any changes in forme fruste keratoconus (FFKC).
Methods:
In this prospective cross-sectional study, 55 eyes of 55 patients with keratoconus and 30 eyes of 30 healthy subjects (control group) were included. Keratoconus group was divided into stage 1, stage 2, stage 3-4 and FFKC groups according to Amsler Krumeich staging system. Morphologic features of the corneal epithelium in three layers, anterior and posterior stroma keratocyte density, subbasal nerve density and length, dendritic cell density were evaluated.
Results:
In the keratoconus group, the cell area of superficial, intermediate and basal epithelial cells increased in parallel with the stage, while the density and circularity decreased. Anterior and posterior stroma keratocyte densities and total, main and branching nerve fiber density and nerve length parameters were significantly decreased in the keratoconus group compared to the control group. No morphologic difference was observed between the keratoconus group and the FFKC group.
Conclusion:
Progressive epithelial, stromal, and neural microstructural alterations were associated with increasing keratoconus severity, whereas no significant changes were detected in FFKC compared with controls. These findings improve understanding of keratoconus pathophysiology and support the potential value of IVCM in characterizing disease-related microstructural changes.
