Morphometry of Corneal Epithelial Cells on Normal Eyes and After Anterior Lamellar Keratoplasty

Purpose: To analyze morphometry of corneal epithelial cells in normal eyes and after anterior lamellar keratoplasty (ALK) using confocal microscopy. Methods: This retrospective comparative case series included 29 eyes of patients who had undergone ALK (ALK group) and 29 subjects before refractive surgery with normal corneas (control group). The Heidelberg Retina Tomograph II with the Cornea Module was used. Images were recorded and analyzed with Image J software. Morphometric parameters used to analyze epithelial cells were cell area, coefficient of variation of cell area, perimeter, circularity, and Feret diameter. Results: Confocal microscopy was performed between 3 and 70 months after surgery. For basal epithelial cells, no significant differences between right eyes and left eyes were found in normal eyes for all morphometric parameters (P < 0.05 and rs > 0.40). The mean epithelial cell area increased during central and vertical migration (migration of epithelial cells from the basal stratum to the outermost layer) (P < 0.001). The mean basal cell area in the central zone was significantly higher (P < 0.001) after ALK in the ALK group than that in the control group. After ALK, the mean basal cell area decreased with postoperative time (rS = -0.78; P < 0.001) and returned to normal 24 months after transplantation (P = 0.27). Comparison of both groups showed significant differences in cell perimeter, circularity, and Feret diameter of basal cells and intermediate cells (P ≤ 0.001). Conclusion: Morphometric analysis of the corneal basal epithelium seems to be a relevant tool to assess the epithelial condition.

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