Confocal microscopy after implantation of intrastromal corneal ring segments

Purpose To evaluate with in vivo confocal microscopy (IVCM) the corneal microstructure changes due to Intrastromal Corneal Ring Segments (ICRS; KERARING Mediphacos Inc., Belo Horizonte, Brazil) implantation. Methods Nine eyes of keratoconic patients were prospectively examined with the HRT 3 confocal microscope with the Rostock cornea module before and 1 month after ICRS implantation. Epithelial basal cell density, endothelial cell density and keratocyte density in the anterior, mid and posterior stroma were measured in the center of the cornea and around ICRS (approximately 3.5 mm off the center of the cornea). Results In the central cornea, we found normal morphologic features at all layers. In peripheral section (near the ICRS) epithelial basal cell density and endothelial cell density were unchanged. However, around the ICRS, keratocyte density increased in the mid stroma (6% increase) and in the posterior stroma (9% increase)(P