Publication: Efecto de la ortoqueratología nocturna en la morfología del epitelio corneal y su relación con la sensibilidad corneal
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2018-09-26
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Universidad Complutense de Madrid
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Abstract
La ortoqueratología (OK) es un método para la reducción o eliminación temporal de los errores refractivos, que consiste en el empleo de lentes de contacto (LC) rígidas permeables a los gases (RGP) para moldear la zona central de la superficie corneal. Sus efectos en la topografía corneal, la agudeza visual, sensibilidad al contraste, calidad óptica del ojo y propiedades biomecánicas se han investigado ampliamente, pero sólo unos pocos estudios han examinado estos efectos en la morfología de la córnea humana. Al respecto, se han reportado cambios en la densidad celular y en el espesor del epitelio corneal, así como en el espesor del plexo nervioso que subyace bajo el epitelio y en el espesor de la membrana de Bowman. La irreversibilidad de los efectos producidos en el espesor del plexo nervioso sub-basal (PNSB) dio lugar a un estudio más profundo del mismo. Sin embargo, aún no se conocían todos los efectos a nivel del mismo.El origen de esta tesis surgió de la necesidad de un estudio prospectivo que analizase cuantitativamente los cambios producidos en los diferentes estratos del epitelio corneal que, según la bibliografía actual, eran susceptibles de necesitar más investigación. Concretamente en el PNSB, donde se estudiaron los efectos de las lentes de OK en su morfología y en la densidad de las células de Langerhans, así como la posible relación de dichos efectos con una alteración sensorial. Por tanto, el objetivo principal de esta tesis fue cuantificar los cambios producidos en el epitelio corneal por un tratamiento de OK a largo plazo y la reversibilidad de los mismos tras el cese de las LC...
Overnight orthokeratology (OK) is a technique used for the temporary reduction of the refractive error, that consists in the use of rigid gas permeable (RPG) contact lenses (LC) to mold the central cornea. Its effects on corneal topography, visual acuity, contrast sensitivity, optical quality of the eye, and biomechanical properties have been widely investigated, though only a few studies have examined the histological effects of this technique on the morphology of the human cornea. Within these studies, changes have been reported changes in the cell density and thicknesses of the corneal epithelium, sub-basal nerve plexus (SBNP) and Bowman´s layer. The irreversible thinning of the Bowman layer and SBNP prompted further study of these layers. However, little is still known about this subject.The origin of this thesis arose from the need for a prospective study that quantitatively analyzed the changes produced in the different strata of the corneal epithelium that, according to the current literature, were likely to require further study. Specifically in the SBNP, where the effects of the OK lenses on its morphology and on the Langerhans cell density were studied, as well as the possible correlation of these effects to a sensorial alteration. Therefore, the main objective of this thesis was to quantify the changes produced in the corneal epithelium due to OK treatment in a long-term period and their reversibility after lens cessation...
Overnight orthokeratology (OK) is a technique used for the temporary reduction of the refractive error, that consists in the use of rigid gas permeable (RPG) contact lenses (LC) to mold the central cornea. Its effects on corneal topography, visual acuity, contrast sensitivity, optical quality of the eye, and biomechanical properties have been widely investigated, though only a few studies have examined the histological effects of this technique on the morphology of the human cornea. Within these studies, changes have been reported changes in the cell density and thicknesses of the corneal epithelium, sub-basal nerve plexus (SBNP) and Bowman´s layer. The irreversible thinning of the Bowman layer and SBNP prompted further study of these layers. However, little is still known about this subject.The origin of this thesis arose from the need for a prospective study that quantitatively analyzed the changes produced in the different strata of the corneal epithelium that, according to the current literature, were likely to require further study. Specifically in the SBNP, where the effects of the OK lenses on its morphology and on the Langerhans cell density were studied, as well as the possible correlation of these effects to a sensorial alteration. Therefore, the main objective of this thesis was to quantify the changes produced in the corneal epithelium due to OK treatment in a long-term period and their reversibility after lens cessation...
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Tesis de la Universidad Complutense de Madrid, Facultad de Óptica y Optometría, Departamento de Óptica II (Optometría y Visión), leída el 07-07-2017