Confocal Microscopy

Advanced Corneal Microscope: Will Vision & Laser Centers continues to lead the way with our ability to provide patients with access to the advanced ConfoScan 4, a state-of-the-art fully digital corneal confocal microscope.  Due to its specialized features and high cost, only a small handful of centers worldwide provide confocal microscopy capabilities. The NIDEK ConfoScan4 is the only instrument that combines confocal microscopy, endothelial microscopy and accurate pachymetry in one unit.

What does Confocal Microscopy Do: Confocal microscopy allows refractive surgeons and corneal specialists to actually look inside the living cornea and diagnose a variety of diseases.  With this biomicroscope, the surgeon can see individual cells in each layer of the cornea in great detail. As a result, this technology can be used for pre operative assessment of corneal health; it can diagnose early signs of keratoconus and dry eye, it can assist in the evaluation of endothelial cell viability, it can be used to measure flap depth following LASIK, it can quantity LASIK interface healing quality and it can provide the surgeon with a view of the epithelial or surface layer to evaluate its overall health.  With very high magnification it is possible to see bacteria, fungi, inflammation and corneal dystrophies as well as tissue damage from drugs or contact lenses.

Evaluate LASIK flaps: After LASIK surgery, the confocal microscope can be used to determine the precise depth of the flap interface, although it can be more cumbersome to use than OCT for that purpose. However, an advantage of confocal microscopy over OCT is that it makes it possible to examine the LASIK interface for debris, observe corneal nerve regeneration, evaluate cell populations in the flap and stromal bed, monitor inflammation and quantify tissue healing.

Examine keratocyte density: Keratocytes constitute the majority of cells in the cornea and are responsible for producing the collagen and high molecular weight matrix that gives the cornea strength and clarity. With confocal microscopy it is possible to quantify the number of keratocytes present in each layer of the cornea as well as monitor them for cell activity or inactivity.

Evaluate blood flow: Using confocal microscopy, blood flow in the capillary networks of the delicate eye tissue can be studied on an outpatient basis without the need for biopsy or other invasive testing. It is possible to observe inflammatory cells and red blood cells move to an area and also watch their activity in real time. This provides the surgeon with a much better understanding of the physiologic processes and disease states that are occurring in any particular patient.