Application of vivo confocal microscopy after Corneal collagen cross link in Keratoconus

Objective To study the characteristics of vivo confocal microscopy after corneal collagen cross link, and to evaluate the efficacy of corneal collagen cross-linking for keratoconus therapy. Methods A total of 23 keratoconus patients (23 eyes) with corneal thickness no less than 400 μm were recruited in this study. Corneal epithelium of central 9 mm was removed mechanically under topical anesthesia, 0.1% riboflavin was applied. Then standard UVA/riboflavin corneal crosslinking was applied. VA, Slit lamp, anterior segment optical coherence tomography (AS-OCT), vivo confocal microscopy was examined and recorded. Results Imaging characteristics in AS-OCT: Preoperative corneal stroma was relatively uniform yellowish green and reflective, postoperative anterior corneal storma emerges relatively dense yellow and green high reflectance, posterior stroma was relatively loose green-based low reflection. Imaging characteristics in vivo confocal microscopy: Preoperative corneal stroma fibers wrinkles showed low reflective stripes, postoperative corneal storma showed high reflective stripes along the dark stripes, and it was more obvious in the anterior storm than the posterior stroma. Conclusions Vivo confocal microscopy shows clear morphological evidence in CXL. UVA/0.1% riboflavin corneal crosslinking achieve conductive riboflavin penetration, and it is safe and effective in the treatment of keratoconus. Key words: Vivo confocal microscopy; UVA/riboflavin corneal crosslinking; Riboflavin; Corneal thickness; Keratoconus