D Dobrowolski

Corneal confocal sub-basal nerve plexus evaluation: a review

The aim of this study was to review the most recent data about corneal sub‐basal nerve plexus (SNP) evaluated with the use of corneal confocal microscopy (CCM). For this purpose, an electronic search was conducted based on PubMed and Google Scholar and Web of Science databases from 2008 up to the end of 2016. Ninety‐eight articles in English were cited, as well as abstracts in other languages, concerning the morphology and function of corneal SNP in various diseases. Changes in corneal SNP as a result of local treatment were also introduced. Figures with scans from confocal microscopy from our Department were included. The main conclusion of this review was that both corneal SNP diminishment and high tortuosity as well as low sensitivity are in principle related to the presence or level of pathology. In addition, increased nerve tortuosity may represent a morphological determinant of nerve regeneration. However, the presented literature shows that SNP changes are not characteristic for one unified corneal pathology; rather, they reflect the non‐specific pathological process present in many diseases. Future studies should use automatized biometric software and also examine the effects of new treatments on SNP.

Epithelial thickness and structure in patients with congenital aniridia after COMET procedure

Purpose To evaluate epithelial structure after COMET procedure in patients with congenital aniridia.

Postoperative astigmatism induction - femtosecondlaser-assisted penetrating keratoplasty vs penetrating keratoplasty

Purpose To compare postoperative astigmatism outcomes of femtosecondlaser‐assisted 110°‐cut PK (FLPK) with conventional PK (PK)in keratoconus patients.

Surgical approach in corneal perforations and deep ulcers

Purpose Outcomes of patch grafts in corneal perforations and deep ulcers.

Cultivating oral mucosa epithelial transplantation (COMET) followed by penetrating keratoplasty (PK) in ocular surface reconstruction

Purpose Efficacy of COMET and subsequent PK in patients with limbal insufficiency combined with stromal corneal haze after corneal burns

Stability of corneal shape and morphology in patients with Fuchs’ dystrophy after phacoemulsification with soft shell technique.

Purpose To evaluate effectiveness of soft shell cataract surgery technique on the corneal structure in group of Fuchs’ dystrophy patients.

Corneal thickness values in case of patients who underwent lamellar keratoplasty using various evaluation techniques.

Purpose To analyze results of pachymetric measurements in patients after deep anterior lamellar keratoplasty (DALK) and endothelial keratoplasty (DSEK) using three techniques of pachymetry estimation. Methods For the study 35 eyes after various lamellar keratoplasty were qualified. 20 eyes they who underwent DSEK (12 women and 8 men) and 15 after DALK (9 men and 6 women). The subjects age ranged from 23 to 92 years old (mean 45.0.1 years). The follow-up ranged from 9 to 31 months (mean 16.8 months). Patients underwent routine DSEK and DALK, using “big bubble” technique, surgery. Pachymetric values were achieved using three devices: ultrasonic pachymeter, specular microscope, Anterior Segment OCT. Pachymetric outcomes were analyzed and compared. Results Total corneal thickness in case of patients who underwent DSEK surgery using ultrasound pachymeter ranged from 581 to 829µm (672.4 ± 89.1), specular microscope registered values from 518 to 719µm (575.4 ± 78.3), OCT Visante ranged from 575 to 911µm (690± 122.1). Total corneal thickness in patients who underwent DALK surgery using ultrasound pachymeter ranged from 382 to 571µm (487 ± 76.8), specular microscope registered values from 380 to 481µm (427 ± 84.2), OCT Visante ranged from 379 to 569µm (439± 143.1). Corneal thickness values received with the use of ultrasound and OCT values significantly differed form obtained using specular microscope. Conclusion Specular microscope seems to omit graft thickness in corneal pachymetry evaluation, also pachymetric outcomes are underrated, even though is able to calculate endothelial cell density in patients who underwent lamellar keratoplasty.