ABSTRACT
In an attempt to correlate basement membrane changes with clinical symptoms we examined 29 specimens from 28 patients who had undergone corneal epithelial basement membranectomy for corneal epithelial basement membrane degeneration (CEBMD). Twenty-two of the 28 patients were women. Recurrent erosion was the most frequent symptom and occurred in 24 of the 29 eyes. The most common electron microscopic finding was reduplication of the basement membrane with loculated connective tissue. The electron microscopic finding that predicted clinical symptoms was absence of the basement membrane and hemidesmosomes, which occurred in 4 eyes with severe recurrent erosion.
Subject(s)
Cornea/ultrastructure , Corneal Diseases/pathology , Adult , Aged , Aged, 80 and over , Basement Membrane/ultrastructure , Corneal Diseases/surgery , Female , Humans , Male , Microscopy, Electron , Middle Aged , Visual AcuityABSTRACT
In a retrospective analysis, 78 eyes in 58 patients that underwent corneal transplantation for Fuchs' endothelial dystrophy were examined for the presence of cataracts. Follow-up ranged from 1 to 17 years, with an average of 6.62 years. Thirty-four (44.1%) of the eyes developed cataracts sufficient enough to require surgical removal. The mean time from transplant to cataract formation averaged 4.9 years. The average age at the time of transplant surgery in the eyes that did not develop cataracts was 55.6, and in those that developed cataracts, 60.3 (p = 0.049). Thirteen percent of the transplants lost transparency following cataract extraction. The incidence of postkeratoplasty cataract increased at age 50 and occurred in 75% of eyes grafted in patients 60 years of age or older.
Subject(s)
Cataract/etiology , Corneal Transplantation/adverse effects , Fuchs' Endothelial Dystrophy/surgery , Adult , Age Factors , Aged , Female , Follow-Up Studies , Humans , Lenses, Intraocular , Male , Middle Aged , Retrospective StudiesABSTRACT
Anterior stromal micropuncture has become an effective treatment for recurrent erosion. The healing process in rabbit corneas was investigated. Following micropuncture of the corneal surface with a 27-gauge needle knife, electron microscopy was carried out at regular intervals from time 0 through 5 months. The corneal incisions began to fill with epithelium by day 1. Activated keratocytes were adjacent to the basement membrane defect by 7 days. The basement membrane appeared to be healed at 2 and 4 weeks. Epithelial projections into the stromal incisions with underlying mature basement membrane persisted at 5 months postsurgery. Basement membrane reproduction occurred much more rapidly following needle puncture than after microdiathermy. This was thought to occur because the corneal epithelial cell was immediately exposed to type I collagen, whereas following microdiathermy, new type I collagen must be secreted on the necrotic collagen before the corneal epithelium will secrete basement membrane.
