Multifocal corneal argyrosis after an explosion injury.
OBJECTIVE
To document the clinical and histopathologic corneal features of a patient who developed multifocal corneal argyrosis after a chemical explosion injury with unusual involvement of the corneal stroma and keratocytes.


METHODS
The corneal button was investigated by light and transmission electron microscopy and scanning electron microscopy combined with energy-dispersive x-ray microanalysis.


RESULTS
Clinically, the patient showed dark discoloration of the lids, periocular skin, episclera, and conjunctiva and had multiple brown dots in the superficial layers of the cornea. Microscopic examination of the cornea showed diffuse deposition of silver particles in the epithelial basement membrane, Bowman's layer, and Descemet's membrane. In the corneal stroma, silver granules accumulated intracellularly within lysosomal structures of degenerative keratocytes and extracellularly in association with collagen fibers and cellular debris. Energy-dispersive x-ray analysis showed peaks of silver and sulfur.


CONCLUSIONS
The toxic influence of intracellular accumulation of silver in stromal keratocytes may lead to cell damage and necrosis and result in visual impairment.
Schlötzer-Schrehardt
U
U
Department Of Ophthalmology, University Nürnberg, Erlangen, Germany. ursula.schloetzer@augen.imed.uni-erlangen.de
Holbach
L M
LM
Hofmann-Rummelt
C
C
Naumann
G O
GO
D001129:Argyria / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002387:Cataract Extraction; D003229:Conjunctival Diseases / Q000209:etiology / Q000473:pathology; D003315:Cornea / Q000737:chemistry / Q000601:surgery / Q000648:ultrastructure; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D065306:Corneal Injuries; D004577:Electron Probe Microanalysis; D005107:Explosions; D005131:Eye Injuries / Q000150:complications*; D005141:Eyelid Diseases / Q000209:etiology / Q000473:pathology; D006801:Humans; D015948:Keratoplasty, Penetrating; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D015422:Scleral Diseases / Q000209:etiology / Q000473:pathology; D012834:Silver / Q000032:analysis; D012880:Skin Pigmentation
D012834:Silver