Retrocorneal membranes. I. Their origin and structure.

Sherrard, Emil S.; Rycroft, P. V.

doi:10.1136/bjo.51.6.379

Cited by 47 publications

(15 citation statements)

References 8 publications

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“…Similar results establishing a stromal source have been obtained in studies of retrocorneal membranes following penetrating keratoplasties. 13,18,19,22 The presence of stromal myofibroblasts in our cases was confirmed by electron microscopy in accord with prior studies. 17,18 The myofibroblasts displayed sufficient contractility to produce wrinkling of the Descemet membrane and displacement of its fragments, 11 as shown in 2 of our specimens.…”

Section: Commentsupporting

confidence: 94%

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Stacy¹

2011

Arch Ophthalmol

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To evaluate retroprosthetic membranes that can occur in 25% to 65% of patients with the Boston type 1 keratoprosthesis (KPro).Methods: Two patients with Peter anomaly and 2 with neurotrophic scarred corneas underwent revisions of their type 1 KPros because of visually compromising retroprosthetic membranes. The excised membranes were studied by light microscopy with hematoxylin-eosin, periodic acid-Schiff, and toluidine blue stains. Immunohistochemical and transmission electron microscopic examination were also used.Results: Light microscopic examination revealed that the retro-KPro fibrous membranes originated from the host's corneal stroma. These mildly to moderately vascularized membranes grew through gaps in the Descemet membrane to reach behind the KPro back plate and adhere to the anterior iris surface, which had undergone partial lysis. In 2 cases, the fibrous membranes merged at the pupil with matrical portions of metaplastic lens epithelium, forming a bilayered structure that crossed the optical axis. Retro-KPro membranes stained positively for ␣-smooth muscle actin but negatively for pancytokeratin. Electron microscopy confirmed the presence of actin filaments within myofibroblasts and small surviving clusters of metaplastic lens epithelial cells.Conclusions: Stromal downgrowth, rather than epithelial downgrowth, was the major element of the retro-KPro membranes in this series. Metaplastic lens epithelium also contributed to opacification of the visual axis. Florid membranous inflammation was not a prominent finding and thus probably not a requisite stimulus for membrane development. Further advances in prosthetic design and newer antifibroproliferative agents may reduce membrane formation.

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Section: Commentsupporting

confidence: 94%

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Stacy¹

2011

Arch Ophthalmol

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“…3 Several studies have suggested that 3 conditions must be present to allow fibrous ingrowth formation: corneal stroma capable of replication, a gap in Descemet's membrane, and the absence of endothelial cells as in cases of poor wound apposition. 3,[4][5][6][7][8] Intraocular lens cocooning has been described by Yeo et al 9 in association with a 4-loop Binkhorst IOL after intracapsular cataract extraction in an adult patient. Due to reccurrent membrane formation, the IOL was explanted 27 months after the initial surgery.…”

Section: Discussionmentioning

confidence: 98%

Cocooning of an iris-fixated intraocular lens in a 3-year-old child after perforating injury: Clinicopathologic correlation

Neuhann

Kleinmann

Apple

et al. 2005

Journal of Cataract and Refractive Surgery

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We present a 3-year-old patient who developed extensive noninflammatory fibrous membrane formation in the anterior chamber involving the present iris-fixated intraocular lens (IOL), with subsequent need for explantation. The child had had repair of a corneal injury, crystalline lens extraction and Artisan iris-claw IOL (Ophthec) implantation after a penetrating injury 2 months before. Histopathologic analyses were consistent with a retrocorneal membrane that originated from the corneal stroma and formed a "cocoon" membrane on the iris-claw IOL.

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“…10,11 Retrocorneal membranes generated by the endothelium are slightly less frequent (9/28) than keratocytic stroma-derived membranes. 5 When the cornea is injured, the wound-healing process in the corneal endothelium seems to consist of 2 distinct pathways: (1) the regenerative pathway, by which endothelial cells are replaced by migration, enlarging, and spreading of the existing endothelial cells; and (2) the nonregenerative pathway (or fibrosis), by which transformed endothelial cells not only resume proliferation but also alter their morphology and collagen phenotypes, leading to the production of an abnormal fibrillar extracellular matrix.…”

Section: Discussionmentioning

confidence: 98%