using in vivo confocal microscope to evaluate the corneal wound healing after various ocular surgeries

Conditions: Corneal Diseases

Summary: although epi-keratome laser-assisted in situ keratomileusis (epi-lasik), penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy are surgeries commonly performed, the time-sequential, in vivo microscopic wound healing process is not fully understood. the purpose of this study is to study the healing of corneal wounds after epi-lasik, penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy by in vivo confocal microscopy, an easily performed and non-invasive procedure. we plan to enroll 40 eyes of 40 patients in each of these three surgeries. in epi-lasik, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and 1, 3, and 7 days after surgery. the eyes are examined weekly in the first month and at 3 and 6 months. for penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and weekly in the first month after surgeries and at 3 and 6 months. selected images of the corneal basal/apical surface epithelia, stromal reactions and corneal endothelial conditions by in vivo confocal microscopy are evaluated qualitatively for the cellular morphology and density.

although epi-keratome laser-assisted in situ keratomileusis (epi-lasik), penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy are surgeries commonly performed, the time-sequential, in vivo microscopic wound healing process is not fully understood. the purpose of this study is to study the healing of corneal wounds after epi-lasik, penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy by in vivo confocal microscopy, an easily performed and non-invasive procedure. we plan to enroll 40 eyes of 40 patients in each of these three surgeries. in epi-lasik, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and 1, 3, and 7 days after surgery. the eyes are examined weekly in the first month and at 3 and 6 months. for penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and weekly in the first month after surgeries and at 3 and 6 months. selected images of the corneal basal/apical surface epithelia, stromal reactions and corneal endothelial conditions by in vivo confocal microscopy are evaluated qualitatively for the cellular morphology and density.

Eligibility criteria:
inclusion criteria: * patients receiving various ocular surgeries * no previous ocular surgery * tear break up time longer than 10 seconds * shirmer test ii larger than 5 mm * no presurgical corneal disease confirmed by slit lamp and in vivo confocal * no limbus defect * proliferative retinopathy underwent vitrectomy combining corneal epithelial scrating exclusion criteria: * can not complete follow up * ineligible for ocular surgery * eyelid closure incomplete * glaucoma * corneal defect or oculoneuropathy not caused by diabetes * severe dry eye disease * limbus defect * pregnant

Keywords: in vivo confocal microscopy vitrectomy corneal transplantation epi-lasik wound healing