The keratoconus epithelium studied by SEM

Jongebloed, W.L.; Worst, J.F.G.

doi:10.1007/bf00142711

Cited by 13 publications

(8 citation statements)

References 8 publications

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“…The epithelium appeared to be thinner in the central region and thicker towards the inferior cornea (Figure 6). Similar pan‐corneal variations in epithelial thickness in keratoconus have been observed using in vitro techniques of light microscopy 30 and transmission 31 and scanning 32 electron microscopy.…”

Section: The Cornea In Keratoconussupporting

confidence: 65%

New perspectives on keratoconus as revealed by corneal confocal microscopy

Efron

Hollingsworth

2008

Clinical and Experimental Optometry

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Confocal microscopy (CM) of keratoconus is reviewed. In the Manchester Keratoconus Study (MKS), slit scanning CM was used to evaluate 29 keratoconic patients and light microscopy (LM) was performed on two of the keratoconic corneas post‐keratoplasty. The findings of the MKS are compared with other CM studies. Consideration of the differences between studies of cell counts is confounded by the use of different experimental controls. A consensus exists among studies with respect to qualitative observations. The epithelium appears more abnormal with increasing severity of keratoconus. In severe disease, the superficial epithelial cells are elongated and spindle shaped, epithelial wing cell nuclei are larger and more irregularly spaced and basal epithelial cells are flattened. Bowman’s layer is disrupted and split in the region of the cone and intermixed with epithelial cells and stromal keratocytes. Stromal haze and hyper‐reflectivity observed with CM correspond with apical scarring seen with the slitlamp biomicroscope (SLB). Hyper‐reflective keratocyte nuclei are thought to indicate the presence of fibroblastic cells. Increased haze detected with CM is found with LM to be due to fibroblastic accumulation and irregular collagen fibres. Dark stromal bands observed with CM correlate with the appearance of Vogt’s striae with SLB. Desçemet’s membrane appears normal with both CM and LM. Some evidence of endothelial cell elongation is observed with CM. The application of CM to ophthalmic practice has facilitated a greater understanding of medical and surgical approaches that are used to treat keratoconus. This review offers new perspectives on keratoconus and provides a framework, against which tissue changes in this visually debilitating condition can be studied in a clinical context in vivo using CM.

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Section: The Cornea In Keratoconussupporting

confidence: 65%

New perspectives on keratoconus as revealed by corneal confocal microscopy

Efron

Hollingsworth

2008

Clinical and Experimental Optometry

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“…Epithelial cells around the rim, appear to be artificially aged, that is cells get detached and take a more or less rounded shape. Similar phenomena have been found at invaginations at the epithelium of keratoconus [14].…”

Section: Discussionsupporting

confidence: 65%

Glass-metal keratoprosthesis: Light and electron microscopical evaluation of experimental surgery on rabbit eyes

et al. 1989

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A keratoprosthesis (KP) is the last and only surgical resort to regain some visual acuity in eyes with severely damaged corneae. Corneal blindness represents an important percentage of the blind in the economically poor countries. Commercially available KP's, e.g. those made of PMMA, which are difficult to sterilize and vulnerable to surface damage, are too expensive in these countries. To overcome these disadvantages, we developed a new KP, made of a glass core melted into a platinum cylinder with flange. They were implanted unilaterally in eyes of ten Hollander rabbits intralamellarly. They were fixated by two stainless steel traction threads passed around the whole eyeball. We investigated this type of KP in the rabbit cornea, its acceptance by stroma, epi- and endothelium, and its hydro-mechanical dynamics in situ. No signs of infection or extrusion were observed. No epithelial downgrowth, nor adverse tissue reaction could be detected. LM and SEM showed endothelialization of the newly formed stroma around the central column of the KP. We conclude that this type of KP (although optically still to be optimized) has been accepted by the rabbit cornea and a clinical trial on cornea-blind patients is justified.

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“…[17][18][19] Higher levels of lysosomal enzyme staining and conjunctival epithelial alterations in patients with keratoconus have been previously reported in full-thickness conjunctival specimens 20 and in conjunctival impression cytology. 21 Dogru et al 6 reported that the ocular surface disease in keratoconus is characterized by a disorder in the tear quality, squamous metaplasia, and goblet cell loss, all of which appear to be related to the extent of keratoconus progression.…”

Section: Discussionmentioning

confidence: 83%