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In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET

Examination of the corneal surface by in vivo confocal microscopy (IVCM) allows for objective identification of corneal and conjunctival cell phenotypes to evaluate different epithelialization patterns. Detection of a corneal-conjunctival epithelial transition could be considered as a sign of restor...

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Autores principales: Pedrotti, Emilio, Chierego, Chiara, Cozzini, Tiziano, Merz, Tommaso, Lagali, Neil, De Gregorio, Alessandra, Fasolo, Adriano, Bonacci, Erika, Bonetto, Jacopo, Marchini, Giorgio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694659/
https://www.ncbi.nlm.nih.gov/pubmed/33171960
http://dx.doi.org/10.3390/jcm9113574
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author Pedrotti, Emilio
Chierego, Chiara
Cozzini, Tiziano
Merz, Tommaso
Lagali, Neil
De Gregorio, Alessandra
Fasolo, Adriano
Bonacci, Erika
Bonetto, Jacopo
Marchini, Giorgio
author_facet Pedrotti, Emilio
Chierego, Chiara
Cozzini, Tiziano
Merz, Tommaso
Lagali, Neil
De Gregorio, Alessandra
Fasolo, Adriano
Bonacci, Erika
Bonetto, Jacopo
Marchini, Giorgio
author_sort Pedrotti, Emilio
collection PubMed
description Examination of the corneal surface by in vivo confocal microscopy (IVCM) allows for objective identification of corneal and conjunctival cell phenotypes to evaluate different epithelialization patterns. Detection of a corneal-conjunctival epithelial transition could be considered as a sign of restored epithelial function following simple limbal epithelial transplantation (SLET). This is a prospective, interventional case series. We assessed patients with limbal stem cell deficiency (LSCD) by IVCM, preoperatively and at monthly intervals following SLET. Sectors in the central and peripheral cornea were scanned. Immediately upon detection of multi-layered cells with the epithelial phenotype in the central cornea and confirmation of epithelial transition in all corneal sectors, the decision for keratoplasty was taken. Ten patients were enrolled. After SLET, epithelial phenotype in the central cornea and an epithelial transition were identified within six and nine months in seven and one patients, respectively. One patient was a partial success and one failed. Five patients underwent keratoplasty, with stable results up to 12 months. Identification of the epithelial transition zone by IVCM permits assessment of the efficacy of SLET, enabling subsequent planning of keratoplasty for visual rehabilitation. The stability of the corneal surface following keratoplasty confirms that the renewal of the corneal epithelium was effectively retained.
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spelling pubmed-76946592020-11-28 In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET Pedrotti, Emilio Chierego, Chiara Cozzini, Tiziano Merz, Tommaso Lagali, Neil De Gregorio, Alessandra Fasolo, Adriano Bonacci, Erika Bonetto, Jacopo Marchini, Giorgio J Clin Med Article Examination of the corneal surface by in vivo confocal microscopy (IVCM) allows for objective identification of corneal and conjunctival cell phenotypes to evaluate different epithelialization patterns. Detection of a corneal-conjunctival epithelial transition could be considered as a sign of restored epithelial function following simple limbal epithelial transplantation (SLET). This is a prospective, interventional case series. We assessed patients with limbal stem cell deficiency (LSCD) by IVCM, preoperatively and at monthly intervals following SLET. Sectors in the central and peripheral cornea were scanned. Immediately upon detection of multi-layered cells with the epithelial phenotype in the central cornea and confirmation of epithelial transition in all corneal sectors, the decision for keratoplasty was taken. Ten patients were enrolled. After SLET, epithelial phenotype in the central cornea and an epithelial transition were identified within six and nine months in seven and one patients, respectively. One patient was a partial success and one failed. Five patients underwent keratoplasty, with stable results up to 12 months. Identification of the epithelial transition zone by IVCM permits assessment of the efficacy of SLET, enabling subsequent planning of keratoplasty for visual rehabilitation. The stability of the corneal surface following keratoplasty confirms that the renewal of the corneal epithelium was effectively retained. MDPI 2020-11-06 /pmc/articles/PMC7694659/ /pubmed/33171960 http://dx.doi.org/10.3390/jcm9113574 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pedrotti, Emilio
Chierego, Chiara
Cozzini, Tiziano
Merz, Tommaso
Lagali, Neil
De Gregorio, Alessandra
Fasolo, Adriano
Bonacci, Erika
Bonetto, Jacopo
Marchini, Giorgio
In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title_full In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title_fullStr In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title_full_unstemmed In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title_short In Vivo Confocal Microscopy of the Corneal-Conjunctival Transition in the Evaluation of Epithelial Renewal after SLET
title_sort in vivo confocal microscopy of the corneal-conjunctival transition in the evaluation of epithelial renewal after slet
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694659/
https://www.ncbi.nlm.nih.gov/pubmed/33171960
http://dx.doi.org/10.3390/jcm9113574
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