In vivo evaluation of corneal wound healing in superficial keratectomy with the tandem scanning confocal microscope

Abstract

Aim: An in vivo study with a tandem scanning confocal microscope (TSM) on the process of keratocyte activation, proliferation, and stromalfibrosis after superficial keratectomy, and nylon suture penetration of rabbit cornea.

Materials and methods: A TSM which would provide improved resolution, magnifiction and contrast, as well as serial optical sectioning ability, was used for real-time examination of the rabbit cornea following superficial keratectomy. Additionally, the effects of nylon suture penetration and stromal revascularization were studied.

Results: Despite an apparently stable slit lamp appearance, with minimal subeoithelial fibrosis, the TSM revealed an actively evolving process of collagen remodelling in the anterior stroma. A suture placed in the stroma was also observed to produce significant tractional forces and tissue displacement. Subsequent stromal fibroblast activation and fibrosis around the nylonwas also observed.

Conclusion : Our results suggest that TSM is a useful and effective instrument in evaluating corneal stromal wound healing at the cellular level.