Corneal Involvement in Uneventful Cataract Surgery: An in vivo Confocal Microscopy Study

Abstract

<b><i>Purpose:</i></b> To evaluate corneal subbasal layer changes after uneventful cataract surgery by means of in vivo confocal microscopy. <b><i>Methods:</i></b> This prospective study included 30 patients. Before surgery, and 1, 3, 6, 8 and 10 months after cataract surgery, all patients underwent a complete ophthalmological and confocal microscopy examination in the central and temporal corneal areas. Number of fibers, beading, tortuosity and reflectivity were analyzed. <b><i>Results:</i></b> Important changes were shown in the central cornea up to 3 months after surgery: a reduction in nerve fiber number (baseline: 4.4 ± 1.7; month 1: 1.2 ± 0.5, p < 0.0001; month 3: 2.5 ± 1.2, p < 0.005) and reflectivity (baseline: 3.6 ± 0.5; month 1: 1.4 ± 0.6, p < 0.0001; month 3: 1.9 ± 0.9, p < 0. 0001), and an increase in beading (baseline: 0.3 ± 0.5 beads/100 µm<sup>2</sup>; month 1: 2.7 ± 0.6 beads/100 µm<sup>2</sup>, p < 0.0001; month 3: 2.6 ± 0.5 beads/100 µm<sup>2</sup>, p < 0. 0001). The confocal parameters completely progressively recovered thereafter (60% at 6 months, 87% at 8 and 10 months). The temporal plexus was absent at 1 month and fully recovered in all patients at month 8. <b><i>Conclusion:</i></b> Uneventful cataract surgery induces relevant corneal modifications when inspected by means of confocal microscopy.