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Evaluation of the microstructure of cornea by in vivo confocal microscopy in contact lens wearing and non-contact lens wearing keratoconus patients

      Abstract

      Purpose

      To compare the microstructure of the central keratoconic cornea in contact lens wearing and non-contact lens wearing keratoconus subjects.

      Methods

      One hundred and one eyes of 56 keratoconic subjects were compared with control patients who wear contact lenses (22 subjects) and controls who do not wear contact lenses (40 subjects). The keratoconic subjects were assessed in 2 groups: the contact lens wearing keratoconus group (37 patients, 64 eyes, 20 female and 17 male; Group 1) and the keratoconus group comprising subjects who do not wear contact lenses (19 patients, 37 eyes, 9 female, 10 male; Group 2).

      Results

      The mean age was 33 ± 12 years in the contact lens wearer keratoconus group, 31 ± 12 years in the non-contact lens wearer keratoconus group, 34 ± 12 years in the non-contact lens wearing control group and 29 ± 10 years in the contact lens wearing control group. Mean basal epithelial cell density was significantly lower in the contact lens wearer keratoconus group (p < 0.001) and in the non-contact lens wearer keratoconus group (p < 0.001) in comparison with controls. The anterior, intermediate and posterior keratocyte densities were significantly lower in both contact lens wearer keratoconic subjects (p < 0.001, p < 0.001, p < 0.001) and non-contact lens wearer keratoconic subjects (p < 0.001, p < 0.001, p = 0.004) as compared to controls. Endothelial cell density was not altered in keratoconic patients.

      Discussion

      The decrease in basal epithelial cell density and in keratocyte density may highlight the role of apoptosis in keratoconus. Endothelial cell density does not change in keratoconus, but extensive variability in endothelial cell size and shape may be encountered.

      Keywords

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      References

        • Rabinowitz Y.S.
        Keratoconus.
        Surv Ophthalmol. 1998; 42: 297-319
        • Cristina K.M.
        • Brown D.J.
        The cascade hypothesis of keratoconus.
        Contact Lens Anterior Eye. 2003; 26: 139-146
        • Wilson S.E.
        • Mohan R.R.
        • Mohan R.R.
        • Ambrósio Jr., R.
        • Hong J.
        • Lee J.
        The corneal wound healing response: cytokine-mediated interaction of the epithelium, stroma and inflammatory cells.
        Prog Retin Eye Res. 2001; 20: 625-637
        • Hollingsworth J.G.
        • Bonshek R.E.
        • Efron N.
        Correlation of the appearance of the keratoconic cornea in vivo by confocal microscopy and in vitro by light microscopy.
        Cornea. 2005; 24: 397-405
        • Lawless M.
        • Coster D.J.
        • Phillips A.J.
        • Loane M.
        Keratoconus: diagnosis and management.
        Aust NZ J Ophthalmol. 1989; 17: 33-60
        • Sawaguchi S.
        • Yue B.Y.
        • Sugar J.
        • Gilboy J.E.
        Lysosomal enzyme abnormalities in keratoconus.
        Arch Ophthalmol. 1989; 107: 1507-1510
        • Zhou L.
        • Sawaguchi S.
        • Twining S.S.
        • Sugar J.
        • Feder R.S.
        • Yue B.Y.
        Expression of degradative enzymes and protease inhibitors in corneas with keratoconus.
        Invest Ophthalmol Vis Sci. 1998; 39: 1117-1124
        • Efron N.
        • Hollingsworth J.G.
        New perspectives on keratoconus as revealed by corneal confocal microscopy.
        Clin Exp Optom. 2008; 91: 34-55
        • Weed K.H.
        • MacEwen C.J.
        • Cox A.
        • McGhee C.N.
        Quantative analysis of corneal microstructure in keratoconus utilising in vivo confocal microscopy.
        Eye. 2007; 21: 614-623
        • Ladage P.M.
        • Yamamoto K.
        • Ren D.H.
        • Li L.
        • Jester J.V.
        • Petroll W.M.
        • et al.
        Effects of rigid and soft contact lens daily wear on corneal epithelium, tear lactate dehydrogenase and bacterial binding to exfoliated epithelial cells.
        Ophthalmology. 2001; 108: 1279-1288
        • Erie J.C.
        • Patel S.V.
        • McLaren J.W.
        • Nau C.B.
        • Hodge D.O.
        • Bourne W.M.
        Keratocyte density in keratoconus. A confocal microscopy study.
        Am J Ophthalmol. 2002; 134: 689-695
        • Edmonds C.R.
        • Wung S.F.
        • Husz M.J.
        • Pemberton B.
        Corneal endothelial cell count in keratoconus patients after contact lens wear.
        Eye Contact Lens. 2004; 30: 54-58
        • Hollingsworth J.G.
        • Efron N.
        • Tullo A.B.
        In vivo confocal microscopy in keratoconus.
        Ophthalmic Physiol Opt. 2005; 25: 254-260
        • Sherwin T.
        • Brookes N.H.
        Morphological changes in keratoconus: pathology or pathogenesis.
        Clin Exp Ophthalmol. 2004; 32: 211-217
        • Kaldawy R.M.
        • Wagner J.
        • Ching S.
        • Seigel G.M.
        Evidence of apoptotic cell death in keratoconus.
        Cornea. 2002; 21: 206-209
        • Mocan M.C.
        • Yilmaz P.T.
        • Irkec M.
        • Orhan M.
        In vivo confocal microscopy for the evaluation of corneal microstructure in keratoconus.
        Curr Eye Res. 2008; 33: 933-939
        • Kallinikos P.
        • Efron N.
        On the etiology of keratocyte loss during contact lens wear.
        Invest Ophthalmol Vis Sci. 2004; 45: 3011-3020