title: A histochemical and x-ray diffraction study of keratoconus epikeratoplasty. Report of two cases.
abstract: Two epikeratoplasty lenticules (Epi-L) with keratoconus host corneas (Epi-H) were removed by penetrating keratoplasty because of poor visual acuity although they were clinically clear. Light microscopy showed that the keratocytes were underpopulated and unevenly distributed in Epi-L. Transmission electron microscopy showed that abnormal sized proteoglycans (PGs) were unevenly accumulated in the stromas of both Epi-L and Epi-H. The low-angle x-ray diffraction results from case 1 showed lower collagen interfibrillar spacings, compared with those from one keratoconus cornea, seven cryolenticules, and four normal human corneas. The fibril diameters and the collagen axial periodicity D were similar in all tissues. Allowing selected samples to swell, the interfibrillar spacing increased by 30.6-45.5% in Epi-H and by 29.8% in the keratoconus control. However, it increased by only 7.6-9.7% in Epi-L and by 11.4% in a cryolenticule. The uneven distribution of PGs and the lower interfibrillar spacings in the swollen lenticules suggest that there is an uneven distribution of water in different parts of the Epi-L and Epi-H stromas. This may lead to a variation of the refractive index or optical properties in the stroma and the deterioration of the visual image, which may explain the poor visual results.
authors.affiliation: Open University, Oxford Research Unit, England.
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.forename: S J
authors.initials: SJ
authors.lastname: Tuft
authors.forename: K M
authors.initials: KM
authors.lastname: Meek
mesh_terms: D000328:Adult; D004396:Coloring Agents; D003315:Cornea / Q000473:pathology* / Q000648:ultrastructure; D016039:Corneal Transplantation; D004577:Electron Probe Microanalysis; D006651:Histocytochemistry; D006801:Humans; D007211:Indoles; D007640:Keratoconus / Q000473:pathology* / Q000601:surgery; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009942:Organometallic Compounds; D013194:Staining and Labeling
chemical_list: D004396:Coloring Agents; D007211:Indoles; D009942:Organometallic Compounds; C015445:copper phthalocyanine