On the morphology of cells of posterior cornea in the iridocorneal endothelial syndrome.

The iridocorneal endothelial (ICE) syndrome is potentially a blinding condition as a result of glaucoma and/or corneal decompensation. The basic pathology seems to be in the corneal endothelium, which many studies confirm takes on a characteristic slit lamp appearance of hammered silver and image reversal with the specular microscope. The origin and morphology of the abnormal cells are unknown. Many histopathological studies of keratoplasty and trabeculectomy specimens reveal as many cell types. This paper reports some general and specular microscopical data from 57 cases of the syndrome, argues that the reason for the variety of histopathological findings in other studies is due to poor sampling of the study material, deduces the morphology of the abnormal cells on specular microscopical criteria, and compares the specular and scanning electron microscopical images in one case with those of other reports. It is tentatively concluded that the appearance of the abnormal cells is a function of their three-dimensional shape and that they produce blister-like vesicles that rupture, collapse, and eventually invaginate.

Lymphangioma circumscriptum of the eyelids and conjunctiva.

A case of lymphangioma circumscriptum of the eyelids and conjunctiva is described. The classification of this disease is given.

The posterior surface of the cornea in the irido-corneal endothelial syndrome: a specular microscopical study.

The corneal endothelia of 21 eyes afflicted with the irido-corneal endothelial (ICE) syndrome have been studied repeatedly with the clinical specular microscope. In all cases a characteristic cell type (the 'ICE-cell') is present but distributed in 4 different patterns. Accordingly, each case could be classified at any one time as one of 4 endothelial variants. One variant, always associated with elevated intraocular pressure (IOP), is characterised by a scattering of ICE-cells throughout the endothelial mosaic. This progresses rapidly to a second variant in which the entire endothelium appears 'replaced' by ICE-cells. In a third variant, associated with normal IOP, ICE-cells 'replace' only a portion of the endothelium which itself shows a great increase in cell numbers/unit area. This, apparently, slowly progresses to a fourth variant which shows a dramatic loss of endothelial cells.

Clinical features of the irido-corneal endothelial syndrome.

Progressive iris atrophy, Chandler's syndrome and the iris naevus syndrome are recognised as subgroups of the irido-corneal endothelial syndrome but in some cases a confusing overlap of the clinical signs is found. The clinical features of five cases selected from 19 patients with this syndrome are described. The findings suggest that the disease can be better subdivided into two groups based on the morphology of the posterior corneal surface as seen with the slit lamp.