FIRST RESULTS OF IN-VIVO VISUALIZATION OF THE TEAR FILM AND STRUCTURES OF THE CORNEA WITH A MODIFIED CONFOCAL LASER-SCANNING OPHTHALMOSCOPE

Background: As the slit-lamp technique is an restrictive method for th e in-vivo examination and documentation of the multi-layer structure a nd the dynamics of the tear film and the cornea, e. g. during wound-he aling processes, our aim was to find out whether it is possible to cha nge the confocal laser scanning ophthalmoscope (CLSO; Zeiss) into a hi gh-resolution confocal laser scanning microscope (CLSM) for the visual ization of the anterior segments of the eye and the tear film by adapt ing a special objective system. in order to gain information concernin g the function of such a cornea microscope we examined selected patien ts with erosion or pterygium before and after operation and subsequent phototherapeutic keratectomy (PTK), as well as some in-vitro corneal surfaces after photorefractive keratectomy (PRK). Material and methods : We developed an objective adapter for the CLSO in order to focus the laser beam onto anterior segments of the eye to visualize the tear fi lm and the layer structure of the cornea. By combining the long-distan ce objective or a contact objective with different zoom-optic lenses i t was possible to alter the scan field size and so the magnification o f the CLSM by a factor of up to 1000. Results: The CLSM provides a new method for the in-vivo examination of the tear film and its dynamics as well as the thin layers of the cornea in real-time imaging techniqu e with high contrast and resolution in noncontact or contact procedure s. Conclusion: This system is a unique tool for evaluating and monitor ing the effect of excimer laser ablation after PTK and PRK on the corn eal surface and the dynamics of the tear film. The application of this method causes no pain for the patient.