Summary: BACKGROUND: To analyse the morphological alterations, epithelial, infammatory and Langerhans cell density of cornea after longstanding bilateral multiple corneal metal foreign body (FB) injury. PATIENT AND METHODS: Clinical records of a 36 years male patient were reviewed and confocal microscopy was performed two and six years after injury. RESULTS: Corneal FBs were situated in 10-156 μm depth. The wing cells were enlarged around FBs (right eye (RE): 3564±95/ mm2, left eye (LE): 3624±73/mm2) on visit 1, but their size decreased by visit 2 (RE: 4121±69/mm2, LE: 3962±71/mm2). No inflammatory cell could be detected while Langerhans cells were randomly seen around FBs (RE: 26±4/mm2, LE: 30±7/ mm2 on visit 1, and RE: 37±4/mm2, LE: 39±5/mm2 on visit 2 respectively). Subbasal nerves were gracile, fragmented around FBs on visit 1, and remained altered on visit 2. CONCLUSION: Our observation may prove that the corneal immune system can tolerate stable intracorneal metal FBs. The longstanding morphological alterations of epithelial cells and subbasal nerves mark the complex impact that such injury can cause.
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