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In vivo Investigation of the Cornea Epithelium with a Confocal Laser Scanning Microscope
1Eckard A., 2Knappe S., 2Sommer U., 2Stave J., 2Guthoff R.,
1Universität Rostock, Augenklinik, Station 1 (Rostock)
2Universität Rostock, Augenklinik (Rostock)
Introduction: By the development of the laser scanning microscope it is possible for the first time to investigate the anterior eye segment in vivo, with precise localisation of the structures. Our aim is a presentation of the cornea epithelium in vivo of normal persons. An atlas of the healthy epithelium is to be provided, later then takes place the inclusion of different illnesses and influences with their morphologic korrelat.
Method: Heidelbergs Retina Tomograph (HRT II), generally is used for the analysis of the papilla in the diagnostic of glaucoma. Using a confocal lens system the imaging plane of the retina is focussed to the anterior segment in combination with an increasing resolution. Without intervening in the hard and software of the equipment, pictures of the cornea with an enlargement to approx. 600 could be achieved. The system works with a contact system without applanation of the cornea. It permits a semiquantitative collection of cell densities of the cornea epithelium, its innervation on height of the Bowman layer, keratocytes as well as structural components and vessels of the conjunctiva and sclera.
Results: The investigations were accomplished with normal inviduals. First results show that the thickness of the epithelium varies at normal people between 60 and 100 µm. On the basis the morphology a distinction between superficialcells, intermediate cells and basal cells is possible. The cell densities vary from at the surface approx. 400 cells/mm² over up to approx. 600 cells/mm² with the intermediate cells to approx. 10,000 cells/mm² within the range of the basal cells.
Conclusions: With this method of the confocal laser microscopy an investigation of the cell distribution and morphology of the epithelium, as well as adjacent cornea and sclera at small expenditure is possible in vivo. It permits - with consideration of the well-known histology - explanations about pathological findings. We could represent e.g. with a female patient with perforating keratoplastik in the center the cornea Langhans-cells. Conclusions on the success of a perforating keratoplastik are thus possibly possible. Furthermore we expect realizations over influences by carrying different contactlenses. An exact representation of the depth of cornea erosions to be and thus leave possible statements about the process of the healing.