[Imaging the tear film and in vivo cornea. Initial results with a modified confocal laser scanning ophthalmoscope].
BACKGROUND
As the slit-lamp technique is an restrictive method for the in-vivo examination and documentation of the multi-layer structure and the dynamics of the tear film and the cornea, e.g. during wound-healing processes, our aim was to find out whether it is possible to change the confocal laser scanning ophthalmoscope (CLSO; Zeiss) into a high-resolution confocal laser scanning microscope (CLSM) for the visualization of the anterior segments of the eye and the tear film by adapting a special objective system. In order to gain information concerning the function of such a cornea microscope we examined selected patients with erosion or pterygium before and after operation and subsequent phototherapeutic keratectomy (PTK), as well as some in-vitro corneal surfaces after photorefractive keratectomy (PRK).


METHODS
We developed an objective adapter for the CLSO in order to focus the laser beam onto anterior segments of the eye to visualize the tear film and the layer structure of the cornea. By combining the long-distance objective or a contract objective with different zoom-optic lenses it was possible to alter the scan field size and so the magnification of the CLSM by a factor of up to 1000.


RESULTS
The CLSM provides a new method for the in-vivo examination of the tear film and its dynamics as well as the thin layers of the cornea in real-time imaging technique with high contrast and resolution in non-contact or contact procedures.


CONCLUSIONS
This system is a unique took for evaluating and monitoring the effect of excimer laser ablation after PTK and PRK on the corneal surface and the dynamics of the tear film. The application of this method causes no pain for the patient.
Stave
J
J
Augenklinik, Universität Rostock.
Guthoff
R
R
D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology / Q000601:surgery; D004867:Equipment Design; D006801:Humans; D054018:Lasers, Excimer; D018613:Microscopy, Confocal / Q000295:instrumentation*; D019721:Ophthalmoscopes; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000473:pathology; D011625:Pterygium / Q000473:pathology / Q000601:surgery; D013666:Tears / Q000166:cytology*; D014945:Wound Healing / Q000502:physiology