Laser Scanning In Vivo Confocal Analysis of Keratocyte Density in Keratoconus

Purpose Keratoconus is a form of progressive noninflammatory corneal ectasia. Although abnormalities have been documented at every level of the keratoconic cornea, the exact underlying pathophysiologic process remains unknown. This study aimed to determine the keratocyte density in human corneas with keratoconus imaged by laser scanning in vivo confocal microscopy. Design Prospective cross-sectional study. Participants Thirty-six eyes of 26 subjects with keratoconus compared with 33 eyes of 33 control subjects. Methods Subjects were assessed via ophthalmic examination, computed topography, and laser scanning in vivo confocal microscopy. Main Outcome Measures Anterior and posterior stromal keratocyte density. Results Mean age was 34.7±12.1 years in the control group, 38.4±11.0 years in the keratoconic with no contact lens wear group, and 38.5±10.3 years in the keratoconic with contact lens wear group. No significant difference was noted in age or gender between the groups. Mean keratocyte density in the control group was 786±244 cells/mm2 in the anterior stroma and 293±35 cells/mm2 in the posterior stroma. Anterior keratocyte density was higher than posterior keratocyte density ( P