title: Laser Scanning In Vivo Confocal Microscopy of Clear Grafts after Penetrating Keratoplasty.
abstract: OBJECTIVE
  To evaluate the changes of keratocytes and dendritic cells in the central clear graft by laser scanning in vivo confocal microscopy after penetrating keratoplasty (PK).
  
  
  METHODS
  Thirty adult subjects receiving PK at Shandong Eye Institute and with clear grafts and no sign of immune rejection after surgery were recruited into this study, and 10 healthy adults were controls. The keratocytes and dendritic cells in the central graft were evaluated by laser scanning confocal microscopy, as well as epithelium cells, keratocytes, corneal endothelium cells, and corneal nerves (especially subepithelial plexus nerves).
  
  
  RESULTS
  Median density of subepithelial plexus nerves, keratocyte density in each layer of the stroma, and density of corneal endothelium cells were all lower in clear grafts than in controls. The dendritic cells of five (16.7%) patients were active in Bowman's membrane and stromal membrane of the graft after PK.
  
  
  CONCLUSIONS
  Activated dendritic cells and Langerhans cells could be detected in some of the clear grafts, which indicated that the subclinical stress of immune reaction took part in the chronic injury of the clear graft after PK, even when there was no clinical rejection episode.
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250012, China.
authors.forename: Dai
authors.initials: D
authors.lastname: Wang
authors.affiliation: Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Song
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250012, China.
authors.forename: Shuting
authors.initials: S
authors.lastname: Wang
authors.affiliation: Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Sun
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250012, China.
authors.forename: Yuexin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, China.
authors.forename: Yangyang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250012, China.
authors.forename: Hua
authors.identifier: 0000-0002-1326-6946
authors.initials: H
authors.lastname: Gao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003316:Corneal Diseases / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D060527:Corneal Keratocytes / Q000276:immunology / Q000473:pathology / Q000648:ultrastructure*; D003713:Dendritic Cells / Q000276:immunology / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006084:Graft Rejection; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D007801:Langerhans Cells / Q000473:pathology / Q000648:ultrastructure; D007834:Lasers; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D019737:Transplants / Q000276:immunology / Q000637:transplantation / Q000648:ultrastructure