Fig. 2: Representative images showing the structural alteration in the corneal stroma by in vivo confocal microscopy (800×). | Eye

Fig. 2: Representative images showing the structural alteration in the corneal stroma by in vivo confocal microscopy (800×).

From: Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

Fig. 2: Representative images showing the structural alteration in the corneal stroma by in vivo confocal microscopy (800×).

Different to the preoperative scan (a), lacunar oedema was visible in the first three postoperative months after primary CXL with trabecular patterned hyperdense tissue surrounding oedematous areas (b). After that, anterior-mid stroma was repopulated by keratocytes and surrounded by extracellular collagen tissue with slightly high density (c, d). Before re-crosslinking, hyper-reflective extracellular tissue surrounding keratocyte nuclei could hardly be seen in the anterior stroma of these patients (e). After re-crosslinking, lacunar oedema in the anterior stroma reappeared and could be observed during the early period postoperatively (f). The depth of cornea oedema could still be observed at 250 μm measured from epithelial surface. Apoptotic keratocytes and activated keratocytes with elongated membrane processes were both detectable from 3 to 6 months postoperatively (g, h). At 12 and 24 months after re-CXL, anterior-mid stroma was repopulated by keratocytes and surrounded by dense extracellular collagen tissue (i, j).

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