Cornea Confocal Microscopy Study of Patients with Preclinical Keratoconus

Abstract

Purpose: To report the difference of corneal confocal microscopy examination in patients with preclinical keratoconus or clinical keratoconus. Methods: 8 unilateral keratoconus patients were examined by confocal microscopy before they had cross-linking surgery. As control groups, 23 patients with myopia and 13 patients with keratoconus in both eyes were also examined by confocal microscopy. Then we used Image J to compared the density of epithelium cell, length of cornea nerve fiber, density of Langerhans cell, density of keratocyte in shallow, middle, deep stroma, and the width and grayscale value of fold near Descement membrane for each group. Result: There was differences in corneal epithelial cell count between three groups (4358.27 ± 635.14 cells/mm² versus 4057.81 ± 316.29 cells/mm² versus 3522.65 ± 978.10 cells/mm²). The density of keratocyte in stroma showed a tendency to decrease with increasing depth. The density of keratocyte in keratoconus was less than that in normal eyes. The fold showed much wider and daker in keratoconus eyes than in normal eyes. The density of Langerhans cell was more in keratoconus group than it in normal group. Conclusion: We first report the differences in corneal epithelial cell count and fold near Descement membrane. It might provide a new way to diagnose early keratoconus. The difference of density of Langerhans cell suggested us the possibility of inflammation in keratoconus.