Confocal microscopy as an evaluation tool of wound healing in corneal surgery

Confocal Microscopy will remain an essential tool to evaluate corneal healing, long-term stability and complications in new refractive procedures, Dr. Maria João Quadrado told delegates yesterday.

“With confocal microscopy we can visualize and quantify corneal structures, infectious organisms, and inflammatory cells,” she said.

“We can visualize and quantify corneal infiltrates after refractive surgery, whether they are infectious or inflammatory,” she added.

She said it can establish the depth of LASIK flaps and it can be used to visualize and quantify epithelial in the anterior chamber, and epithelial cells in the endothelium.

Dr. Quadrado began with an overview of the technology and the scope of its applications, noting its relevance to wound healing for any procedure, whether LASIK, PRK, PK, DSAEK, DLAK or others.

Confocal Microscopy is an important tool for studying cystic diseases, dystrophy, graft rejection, deposits, or microorganisms like acanthamoeba or fungus.

A particular strength is its ability to deliver images from every level, from superficial epithelium to basal cells, the anterior and posterior stroma and the endothelium. It was a key technology in many studies and the means for new insights to old problems.

She noted that confocal studies had help show that reflective particle density at the flap interface did not correlate with flap thickness, haze intensity or ablation depth. It has shown that particles can have variable size and reflectivity, particles decrease with time and stabilise at six months.

Dr. Quadrado next surveyed briefly the impact of confocal microscopy on our understanding of wound healing for certain procedures, and illustrated how the technique can characterise the wound healing profiles of different techniques. It will, she concluded, remain an essential tool.