{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:26:27Z","timestamp":1775024787522,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In vivo confocal microscopy (IVCM) provides high-resolution corneal imaging that may enhance preoperative and postoperative assessment in refractive surgery. This pilot study aimed to evaluate the diagnostic utility of IVCM in identifying subclinical corneal abnormalities that could influence surgical qualification and outcomes. Methods: A total of 7 patients (3 males, 4 females; mean age 48.8 \u00b1 14.5 years) undergoing qualification or follow-up for refractive surgery were prospectively examined between May 2021 and March 2025. Each participant underwent a comprehensive ophthalmic evaluation, including slit-lamp biomicroscopy, corneal topography, anterior segment optical coherence tomography (AS-OCT), and IVCM using the Heidelberg Retina Tomograph II with Rostock Cornea Module. Patients with prior ocular surgery, active infection, or systemic corneal disease were excluded. Results: IVCM revealed subtle epithelial, stromal, and endothelial abnormalities undetectable by conventional methods. Findings such as Thygeson\u2019s keratitis, pre-Descemet\u2019s dystrophy, and subclinical herpes simplex keratitis led to modifications of surgical plans or disqualification in selected cases. The technique also aided postoperative evaluation of epithelial\u2013stromal interface disorders. Conclusions: IVCM proved to be a valuable adjunct in detecting subclinical corneal pathology, refining patient selection, and improving safety in refractive surgery. Larger multicenter studies are warranted to validate its clinical role and define standardized indications for preoperative screening.<\/jats:p>","DOI":"10.3390\/jcm14217714","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:28:43Z","timestamp":1761888523000},"page":"7714","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enhancing Safety in Refractive Surgery: A Pilot Evaluation of In Vivo Confocal Microscopy"],"prefix":"10.3390","volume":"14","author":[{"given":"Dominika","family":"Janiszewska-Bil","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, Poland"},{"name":"Collegium Medicum, WSB University, 41-300 Dabrowa Gornicza, Poland"},{"name":"Department of Ophthalmology, Faculty of Medicine, Academy of Silesia, 40-555 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0267-7835","authenticated-orcid":false,"given":"Magdalena","family":"Kijonka","sequence":"additional","affiliation":[{"name":"Chair and Ophthalmology Clinic Railway Hospital Katowice, Medical University of Silesia, 40-760 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Kokot-Lesiuk","sequence":"additional","affiliation":[{"name":"Chair and Ophthalmology Clinic Railway Hospital Katowice, Medical University of Silesia, 40-760 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Derhartunian","sequence":"additional","affiliation":[{"name":"EyeLaser Clinic, Opernring 1, 1010 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4405-8020","authenticated-orcid":false,"given":"Anita","family":"Lyssek-Boro\u0144","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, Poland"},{"name":"Department of Ophthalmology, Faculty of Medicine, Academy of Silesia, 40-555 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8768-1691","authenticated-orcid":false,"given":"Dariusz","family":"Dobrowolski","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, Poland"},{"name":"Chair and Ophthalmology Clinic Railway Hospital Katowice, Medical University of Silesia, 40-760 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Wyl\u0119ga\u0142a","sequence":"additional","affiliation":[{"name":"Chair and Ophthalmology Clinic Railway Hospital Katowice, Medical University of Silesia, 40-760 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1633-7145","authenticated-orcid":false,"given":"Beniamin Oskar","family":"Grabarek","sequence":"additional","affiliation":[{"name":"Collegium Medicum, WSB University, 41-300 Dabrowa Gornicza, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9737-5391","authenticated-orcid":false,"given":"Katarzyna","family":"Krysik","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, St. Barbara Hospital, Trauma Centre, 41-200 Sosnowiec, Poland"},{"name":"Department of Ophthalmology, Faculty of Medicine, Academy of Silesia, 40-555 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1038\/s41433-020-1096-5","article-title":"Refractive Surgery beyond 2020","volume":"35","author":"Ang","year":"2021","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Miraftab, M., Hashemi, H., Aghamirsalim, M., Fayyaz, S., and Asgari, S. 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