title: In vivo confocal microscopic evaluation of corneal wound healing after femtosecond laser-assisted keratoplasty.
abstract: OBJECTIVE
  To evaluate corneal wound healing after femtosecond laser-assisted keratoplasty (FLAK) using in vivo confocal microscopy (IVCM).
  
  
  METHODS
  Prospective, interventional, consecutive case series of 17 eyes after mushroom-shaped FLAK. IVCM was performed preoperatively and at 1, 3, 6, and 12 months postoperatively to assess wound healing.
  
  
  RESULTS
  Mean keratocyte activation grade increased from preoperative levels to 1 month postoperatively in both the central (0.41 ± 0.62 to 1.73 ± 1.03) and peripheral (0.47 ± 0.52 to 1.57 ± 1.09) cornea, then gradually decreased through 12 months. Dendritic cells increased from preoperatively to 1 month postoperatively in both the central (0.71 ± 0.83 to 1.33 ± 0.98) and peripheral (0.79 ± 0.70 to 1.42 ± 0.90) cornea, then gradually decreased until 6 months postoperatively. Stromal reinnervation was 1 month postoperatively in 8 patients (50%). By 12 months, sub-epithelial nerves were observed centrally in 5 patients (45.5%).
  
  
  CONCLUSIONS
  IVCM after FLAK shows an initial increase in keratocyte activation and dendritic cells that decrease over time. Corneal reinnervation is seen as early as 1 month postoperatively.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, Ann Arbor, MI 48105, USA. ronim@med.umich.edu
authors.forename: Roni M
authors.initials: RM
authors.lastname: Shtein
authors.forename: Kurt H
authors.initials: KH
authors.lastname: Kelley
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
authors.forename: Shahzad I
authors.initials: SI
authors.lastname: Mian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003315:Cornea / Q000502:physiology*; D060527:Corneal Keratocytes / Q000502:physiology; D003319:Corneal Stroma / Q000294:innervation; D016039:Corneal Transplantation / Q000379:methods*; D003713:Dendritic Cells / Q000166:cytology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D054018:Lasers, Excimer; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology; D009882:Ophthalmic Nerve / Q000502:physiology; D011446:Prospective Studies; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult