Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
J Refract Surg. 2011 Jun;27(6):444-50. doi: 10.3928/1081597X-20101201-01. Epub 2010 Dec 1.
To examine the corneal collagen cross-linking (CXL) effect with a customized epithelial debridement technique in thin corneas using anterior segment optical coherence tomography (OCT) and confocal microscopy.
Two patients with keratoconus who underwent a customized epithelial debridement technique (preserving the epithelium in thinner corneal regions where the deepithelialized corneal thickness was <400 μm) and subsequent CXL were examined by anterior segment OCT and in vivo confocal microscopy 1 month postoperatively.
Anterior segment OCT showed the demarcation line in the peripheral deepithelialized corneal areas, but it was not detectable in the central corneal regions corresponding to the cone where the epithelium was preserved. In vivo confocal microscopy analysis revealed total loss of keratocytes together with the intense honeycomb-like stromal edema in the anterior ∼320 μm of the cornea in the deepithelialized areas. This effect was mild under the intact epithelium with preservation of keratocytes and only a mild increase in stromal reflectivity.
In this confocal microscopy study, the corneal stroma under the intact epithelium seemed to be spared from the collagen CXL effect by the customized epithelial debridement technique.
使用眼前节光学相干断层扫描（OCT）和共聚焦显微镜检查使用定制上皮清创技术在薄角膜中进行的角膜胶原交联（CXL）效果。
对 2 例接受定制上皮清创术（在深上皮化角膜厚度<400μm 的较薄角膜区域保留上皮）的圆锥角膜患者进行研究，随后进行 CXL，并在术后 1 个月进行眼前节 OCT 和共聚焦显微镜检查。
眼前节 OCT 显示在外周深上皮化角膜区域有分界线，但在与保留上皮的圆锥相对应的中央角膜区域无法检测到。共聚焦显微镜分析显示，在前 320μm 角膜的深上皮化区域，所有角膜基质细胞丢失，伴有强烈的蜂窝状基质水肿。在保留角膜基质细胞且基质反射率仅轻度增加的完整上皮下，这种效应较为轻微。
在这项共聚焦显微镜研究中，通过定制上皮清创术，完整上皮下的角膜基质似乎免受胶原 CXL 效应的影响。
