Abstract
Purpose. To study morphological changes in the cornea by confocal microscopy of simultaneous MyoRing implantation with corneal crosslinking in patients with keratoconus. Material and methods. The clinical study included 15 patients (16 eyes) with progressive keratoconus. All patients underwent a combination treatment: implantation of MyoRing intrastromal corneal rings (Dioptex GmBH, Linz, Austria) in combination with corneal crosslinking. The number of cells and quality indicators in each layer of the cornea were compared before and during 36 months after surgery. Results. Qualitative analysis of the cornea showed transient disturbances of the subepithelial nerve plexus, an increase in the reflectivity of stromal keratocytes, and moderate fibroplasia in the middle parts of the stroma in the area of the intrastromal pocket. During the follow-up period of 12 months or more after surgery, no significant changes in the corneal ultrastructure were detected in the dynamics. There was no significant decrease in endothelial cell density in the postoperative period. Conclusion. Analysis of morphological changes confirms the safety of a combination of simultaneous implantation of the MyoRing intrastromal ring and corneal crosslinking in stage II-III keratoconus by confocal microscopy and allows dynamic observation of changes in the corneal structure during intrastromal surgery. Key words: keratoconus, confocal microscopy, intrastromal corneal rings, MyoRing, corneal crosslinking.
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