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https://ptsldigital.ukm.my/jspui/handle/123456789/519855| Title: | Confocal microscopy observation on keratoconus patients wearing different types of contact lenses |
| Authors: | Somnath Ghosh (P66148) |
| Supervisor: | Haliza Abdul Mutalib, Associate Prof. Dr. |
| Keywords: | Keratoconus Non-inflammatory disease Visual impairment Contact lenses Dissertations, Academic -- Malaysia |
| Issue Date: | 19-Feb-2017 |
| Description: | Keratoconus is a non-inflammatory disease that adversely affects the corneal cell morphology (CCM) leading to significant visual impairment. Visual rehabilitation of keratoconus is commonly done with several types of contact lenses. The present study was carried out to observe the CCM in neophyte keratoconus patients wearing different types of contact lenses by using slit-scanning confocal microscope at baseline and after one year of contact lens wear. In the 1st part, a cross-sectional study was conducted to evaluate the CCM of 47 keratoconic eyes and 32 healthy eyes as age matched controls. In the 2nd part, a prospective longitudinal study was performed to observe the CCM in keratoconus patients (n=40) wearing regular design rigid gas-permeable (RRGP), specially designed rigid gas-permeable (SRGP) and mini-scleral (MS) contact lenses. At baseline, in keratoconic eyes, increased stromal haze, alterations like elongation and clustering of keratocyte nuclei in anterior stroma, dark bands in posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte density and area between mild, moderate and severe keratoconus were significantly different (p<0.001 & p<0.044 respectively). After one year of contact lens wear, CCM was noticeably different from baseline observation in keratoconus patients. In RRGP group, the anterior and posterior stromal haze were increased in 18.74% and 23.81% eyes respectively after one year of contact lens wear. The mean anterior and posterior stromal keratocyte density and area were significantly different (p<0.05) after one year. However, the difference was not significant in endothelium (p>0.05). The polymegathism and pleomorphism were increased by 3.91% and 14.85% respectively after one year. In SRGP group, the anterior and posterior stromal haze were increased in 16.67% and 11.11% eyes respectively after one year. Statistically significant changes (p<0.05) was observed in anterior stromal keratocyte density and area after one year. However, the differences were not significant in posterior stroma and endothelium (p>0.05). The polymegathism and pleomorphism were increased by 2.65% and 14.79% respectively after 1 year. No noticeable alterations in corneal microstructure were seen in a patient with keratoconus wearing MS contact lens for one year. Confocal microscopy observation showed different morphological alterations in keratoconic corneas wearing different types of contact lenses. Hence, understanding of CCM and consequences of fitting different types of contact lenses can help in better management of keratoconus.,Ijazah Doktor Falsafah |
| Pages: | 199 |
| Call Number: | WW20.G427c 2017 9 |
| Publisher: | UKM, Kuala Lumpur |
| Appears in Collections: | Faculty of Health Sciences / Fakulti Sains Kesihatan |
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|---|---|---|---|---|
| ukmvital_98004+Source01+Source010.PDF Restricted Access | 226.55 kB | Adobe PDF |  View/Open |
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