ABSTRACT
Eight human corneal lenticules (three from keratophakia, two from hypermetropic keratomileusis, and three from myopic keratomileusis) were examined by light and electron microscopy. The keratophakic lenticules were removed for optical reasons 3, 3.5, and 6 months after surgery. Microscopically, all displayed hypocellularity, mature collagen fibrils and microfibrils, keratocyte ghosts, and keratocytic debris. The hypermetropic keratomileusis specimens were removed at 13 and 14 months postoperatively, the first because of opacities from enzymatic digestion of the cornea, and the second due to contact lens-induced erosion of Bowman's layer and decreased lacrimal secretion. Ultrastructurally, both lenticules exhibited fractures in Bowman's layer, and the 14-month specimen showed multilayered squamous epithelia. The myopic keratomileusis specimens were removed at 4, 8, and 48 months postoperatively due to opacification of the interface caused by delayed epithelial healing, detergent trauma, and previous epithelization, respectively. Electron microscopy revealed fractures in Bowman's layer, subepithelial fibrocellular growth, sparse keratocyte populations of the anterior stroma, porous collagen bundles, keratocytic debris, and regions of epithelial ingrowth.
Subject(s)
Cornea/ultrastructure , Corneal Stroma/ultrastructure , Postoperative Complications/pathology , Adult , Aged , Cornea/surgery , Corneal Stroma/surgery , Cryosurgery/adverse effects , Female , Humans , Hyperopia/surgery , Male , Middle Aged , Myopia/surgery , Refractive Surgical ProceduresABSTRACT
The eyes of an AIDS patient with cytomegalovirus (CMV) retinitis and pneumonitis who died while receiving maintenance therapy with the antiviral agent 9-[2-hydroxy-1-(hydroxymethyl) ethoxymethyl] guanine (Ganciclovir) were obtained for pathological examination. While under treatment the patient had significant improvement but not complete regression of retinitis. Electron microscopic and immunofluorescent techniques revealed cytomegalovirus particles in the retina, sclera, iris, and ciliary body. These findings are consistent with a virostatic type of inhibition of CMV by this agent. They also suggest that CMV involvement in the eye and other organs may be more widespread than is clinically apparent in AIDS patients.
Subject(s)
Acquired Immunodeficiency Syndrome/microbiology , Acyclovir/analogs & derivatives , Antiviral Agents/therapeutic use , Cytomegalovirus/isolation & purification , Eye/microbiology , Acquired Immunodeficiency Syndrome/drug therapy , Acquired Immunodeficiency Syndrome/pathology , Acyclovir/therapeutic use , Adult , Ciliary Body/microbiology , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/microbiology , Ganciclovir , Humans , Iris/microbiology , Male , Retina/ultrastructure , Retinitis/complications , Retinitis/drug therapy , Retinitis/microbiologyABSTRACT
Conjunctival biopsy from a 39-year-old man with the acquired immune deficiency syndrome revealed the presence of herpes virus particles by electron microscopy. The finding of herpes virus particles in the conjunctiva may be of prognostic significance in documenting the presence of systemic viral infection.
