Corneal Diseases
Conditions
Keywords
in vivo confocal microscopy, vitrectomy, corneal transplantation, Epi-LASIK, wound healing
Brief summary
Although epi-keratome laser-assisted in situ keratomileusis (Epi-LASIK), penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy are surgeries commonly performed, the time-sequential, in vivo microscopic wound healing process is not fully understood. The purpose of this study is to study the healing of corneal wounds after Epi-LASIK, penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy by in vivo confocal microscopy, an easily performed and non-invasive procedure. We plan to enroll 40 eyes of 40 patients in each of these three surgeries. In Epi-LASIK, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and 1, 3, and 7 days after surgery. The eyes are examined weekly in the first month and at 3 and 6 months. For penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and weekly in the first month after surgeries and at 3 and 6 months. Selected images of the corneal basal/apical surface epithelia, stromal reactions and corneal endothelial conditions by in vivo confocal microscopy are evaluated qualitatively for the cellular morphology and density.
Detailed description
Although epi-keratome laser-assisted in situ keratomileusis (Epi-LASIK), penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy are surgeries commonly performed, the time-sequential, in vivo microscopic wound healing process is not fully understood. The purpose of this study is to study the healing of corneal wounds after Epi-LASIK, penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement for diabetic retinopathy by in vivo confocal microscopy, an easily performed and non-invasive procedure. We plan to enroll 40 eyes of 40 patients in each of these three surgeries. In Epi-LASIK, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and 1, 3, and 7 days after surgery. The eyes are examined weekly in the first month and at 3 and 6 months. For penetrating keratoplasty and pars plana vitrectomy with corneal epithelial debridement, slit-lamp biomicroscopy, in vivo confocal microscopy, and visual acuity are recorded before and weekly in the first month after surgeries and at 3 and 6 months. Selected images of the corneal basal/apical surface epithelia, stromal reactions and corneal endothelial conditions by in vivo confocal microscopy are evaluated qualitatively for the cellular morphology and density.
Interventions
None listed
Sponsors
National Taiwan University Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* patients receiving various ocular surgeries * no previous ocular surgery * tear break up time longer than 10 seconds * Shirmer test II larger than 5 mm * no presurgical corneal disease confirmed by slit lamp and in vivo confocal * no limbus defect * proliferative retinopathy underwent vitrectomy combining corneal epithelial scrating
Exclusion criteria
* can not complete follow up * ineligible for ocular surgery * eyelid closure incomplete * glaucoma * corneal defect or oculoneuropathy not caused by diabetes * severe dry eye disease * limbus defect * pregnant
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| cellular morphology and density | before surgery and 1, 3, and 7 days after surgeryfirst month and at 3 and 6 months |
Secondary
| Measure | Time frame |
|---|---|
| visual acuity | before and 1, 3, and 7 days after surgery, first month and at 3 and 6 months |
| corneal basal/apical surface epithelia, stromal reactions and corneal endothelial conditions | before and 1, 3, and 7 days after surgery, first month and at 3 and 6 months |
Countries
Taiwan
Outcome results
None listed