[Pathology of the corneal endothelium in bullous keratopathy following iris clip lens implants].
12 patients developed pseudophakic bullous keratopathy 2 to 7 years following i.c. cataract-extraction with implantation of 4-loop iris clip lenses necessitating perforating keratoplasty. To study the pathogenesis of pseudophakic bullous keratopathy the corneal endothelium of the excised button was investigated light-microscopically after vital staining of the endothelium. Additionally the surface of the explanted intraocular lenses were examined by the method of Wolter. The result is a central cell density of the excised corneal buttons between 179 and 867 cells/mm2. Large cell-free areas were always found indicating that a disturbance of the endothelial barrier function is the major reason for corneal decompensation. A relation between inflammatory cell deposits on the IOL-surfaces and the endothelial decompensation was not apparent. As the main reason for endothelial decompensation a chronical mechanically induced endothelial cell loss is supposed leading to disturbances of the endothelial barrier function. To prevent a repeated corneal decompensation it is recommended to remove iris-clip-lenses during the procedure of perforating keratoplasty.
Daus
W
W
Universitätsaugenklinik Heidelberg.
Völcker
H E
HE
Homberg
A
A
D000368:Aged; D000369:Aged, 80 and over; D002452:Cell Count; D003316:Corneal Diseases / Q000473:pathology* / Q000601:surgery; D004728:Endothelium, Corneal / Q000473:pathology*; D006801:Humans; D015948:Keratoplasty, Penetrating; D007910:Lenses, Intraocular; D011183:Postoperative Complications / Q000473:pathology* / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D014821:Vitrectomy
Pathologie des Hornhaut-Endothels bei der bullösen Keratopathie nach Iris-Cliplinsen-Implantation.