Recurrence of Posterior Polymorphous Corneal Dystrophy After Penetrating Keratoplasty

Boruchoff, S. Arthur; Weiner, Mark J.; Albert, Daniel M.

doi:10.1016/s0002-9394(14)74559-3

Cited by 25 publications

(11 citation statements)

References 7 publications

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“…It was postulated previously that this fibrous layer contains fibroblasts and is formed by aberrant epithelial-like cells (Boruchoff et al 1990;Sekundo et al 1994). In our study we were unable to determine the origin of the cells in the PCL.…”

Section: Discussioncontrasting

confidence: 56%

“…Thus the proportion of surviving donor endothelial cells in the PPCD graft was less than 1%. It was postulated earlier that after keratoplasty of PPCD patients, the healthy donor endothelium could be destroyed by proliferating and migrating host epithelial-like endothelial cells or could be eliminated by immunological mechanisms and then repopulated by the host cells (Boruchoff et al 1990;Sekundo et al 1994). We suggest that in our case the major factor contributing to the almost total lack of donor endothelial cells in the graft was the presence of host epithelial-like PPCD cells migrating from the periphery of the recipient's cornea.…”

Section: Discussionmentioning

confidence: 49%

“…Nuclei were counterstained with DAPI (violet). Scale bar represents 10 lm have been clearly documented in the literature, of which only 3 were examined by light and electron microscopy (Boruchoff et al 1990;Krachmer 1985;Sekundo et al 1994). On the basis of morphology it has been suggested that PPCD recurrence is caused by the migration of the host endothelium (Sekundo et al 1994), but so far no proof has been provided for this hypothesis, thus the possibility remained that the donor endothelium undergoes metaplasia triggered by unknown factors.…”

Section: Discussionmentioning

confidence: 99%

“…The first clinical description of PPCD recurrence after penetrating keratoplasty (PK) was provided by Krachmer (1985). Boruchoff et al (1990) documented recurrence in an explanted corneal button using light microscopy and histological examination. Sekundo et al (1994) showed the presence of an epithelium-like endothelium on the posterior surface of three other grafted PPCD specimens using light and electron microscopy.…”

Section: Introductionmentioning

confidence: 99%

“…Sekundo et al (1994) showed the presence of an epithelium-like endothelium on the posterior surface of three other grafted PPCD specimens using light and electron microscopy. It was suggested that these abnormal cells were host in origin and that they had overgrown onto the donor posterior corneal surface (Boruchoff et al 1990;Sekundo et al 1994). However, no direct proof supporting this theory was provided.…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of posterior polymorphous corneal dystrophy is caused by the overgrowth of the original diseased host endothelium

Merjava

Malinova

Lišková

et al. 2011

Histochem Cell Biol

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Posterior polymorphous corneal dystrophy (PPCD) is a rare, bilateral autosomal dominant disorder affecting primarily the corneal endothelium and descemet membrane (DM). The aim of this study was to establish the origin of abnormal endothelium in a patient with PPCD exhibiting cornea graft failure after keratoplasty surgery. A sex-mismatched graft obtained from a patient with PPCD who underwent repeat penetrating keratoplasty and the patient's original cornea were investigated. Combined fluorescent immunohistochemistry for cytokeratin (CK) 19 (a marker of aberrant PPCD endothelium) with fluorescence in situ hybridization (FISH) of the sex chromosomes were used in order to characterize the cells on the posterior graft surface. The pathological endothelium of the failed PPCD cornea revealed strong positivity for CK19 using fluorescent immunohistochemistry. In all the CK19-positive cells, both X and Y chromosomes were simultaneously detected using FISH. The results clearly showed the original cells of the patient (XY), within 3.5 years, almost totally overgrown the posterior corneal surface of the graft (XX). Moreover, an abnormal posterior collagenous layer populated by fibroblast-like cells was observed between DM and the endothelium in the failed graft, but its exact origin could not be established due to the low number of cells. Simultaneous detection of CK19 using fluorescent immunohistochemistry together with the detection of gonosomes using FISH was performed for the first time in the cornea and allowed us to prove that the recurrence of PPCD was caused by pathological abnormal proliferation and migration of recipient cells into donor graft.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 49%