Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerouvectomy is an effective method of treatment.
Adenoma ; pathology ; Adult ; Ciliary Body ; pathology ; Epithelium, Corneal ; pathology ; Humans ; Male ; Pigment Epithelium of Eye ; pathology ; Uveal Neoplasms ; pathology

No abstract available.
Adult ; Cataract Extraction/*adverse effects ; Corneal Edema/diagnosis/*etiology ; Corneal Stroma/*pathology ; Epithelium, Corneal/*pathology ; Female ; Hallermann's Syndrome/*complications/diagnosis ; Humans ; Lens Implantation, Intraocular

To evaluate the efficacy of amniotic membrane in the management of painful bullous keratopathy secondary to the intractable glaucoma and in preventing exposure of drainage devices, we inserted Ahmed valve with amniotic membrane patch graft over the implant itself, and debrided corneal epithelium with amniotic membrane graft over the exposed stroma as a single operation. During the follow-up periods, we monitored vision, intraocular pressure (IOP), presence of ocular pain, and postoperative complications associated with the implants. The mean follow up period was 8.4+/-3.2 months. IOP was well controlled after the intervention. The preoperative mean IOP was measured as 43.9+/-9.0 mmHg and lowered to 16.1+/-1.8 mmHg at the last visit and no complications associated with the implants were noted. Even though the improvement in vision was not prominent, the ocular surface stabilized rapidly and ocular pain associated with bullous keratopathy disappeared soon after surgery. Conclusively the use of amniotic membrane in conjunction with Ahmed valve implantation is an effective way to relieve ocular pain and lessen the chances of complications associated with the implant in patients with intractable glaucoma and bullous keratopathy.
Retrospective Studies ; Middle Aged ; Male ; Humans ; *Glaucoma Drainage Implants ; Glaucoma/complications/surgery ; Female ; Epithelium, Corneal/pathology/surgery ; Corneal Transplantation/*methods ; Corneal Diseases/etiology/pathology/*surgery ; Amnion/*transplantation ; Aged

PURPOSE: In this study, we evaluated the results of PTK(phototherapeutic keratectomy) for granular corneal dystrophy. METHODS: 5 eyes (4 patients) with granular corneal dystrophy were treated by PTK using Summit ExiMed UV200 and VSIX Star excimer laser systems. The epithelium was removed mechanically with a surgical blade. We used methylcellulose 1.0% as a surface modulator before laser ablation. Focal ablations of the central cornea with an ablation zone of 6.0 mm were performed. Mean ablation depth was 105 +/- 15.81 micrometer (range; 80~120 micrometer) Additional hyperopic PRK was performed on 4 eyes out of 5 eyes at the corneal mid-periphery up to maximum +5.00 D to prevent post-PTK hyperopic shift. Mean follow up period was 54.4 +/- 23.43months (range; 24~84months). RESULTS: Removal of corneal opacities allowed for improvement in both uncorrected visual acuity and best corrected visual acuity in all patients. There was an improvement in best-corrected visual acuity of a mean of 2.6 lines on the Snellen chart. Mean corneal thickness in the area of pathology decreased from 490.5 micrometer before surgery to 391.5 micrometer after surgery. There was a hyperopic shift in all the eyes in spite of additional hyperopic PRK by a mean of +2.44 +/- 0.99 D. There was mild recurrent dystrophic change in an eye but not significant enough to affect visual acuity during the follow up period. No major complications developed in any patients. CONCLUSIONS: Our results suggest that PTK is a safe and effective alternative to penetrating and lamellar keratoplasty in patients with granular corneal dystrophy. Mild post-PTK hyperopic shift occurred in all patients in spite of combined hyperopic PRK up to maximum +5.00 D correction at the corneal mid- peripheral zone according to the refractive powers.
Cornea ; Corneal Opacity ; Corneal Transplantation ; Epithelium ; Follow-Up Studies ; Humans ; Laser Therapy ; Lasers, Excimer ; Methylcellulose ; Pathology ; Visual Acuity

PURPOSE: Neurotrophic keratitis is corneal epithelial defects and stromal thinning associated with loss of sensory function in the ophthalmic branch of the trigeminal nerve. The purpose of this study was to determine the ultrastructural changes of corneal epithelium and basement membrane in neurotrophic keratitis. METHODS: The corneal tissues were obtained from the elevated margin of corneal ulcer in 5 patients with neurotrophic keratitis. Electron microscopic studies were performed. RESULTS: Degenerated epithelial cells, widened intercellular spaces and infiltrated inflammatory cells were observed. In addition, discontinuous basement membrane and loss of adhesion complex including hemidesmosome, anchoring fibril and anchoring plaque were found. CONCLUSIONS: These results suggest that ultrastructural pathology of persistent epithelial defect and inadequate healing of neurotrophic keratitis are loss of adheson complex, discontinuous basement membrane, degenerated epithelial cells, and infiltrating inflammatory cells.
Basement Membrane* ; Corneal Ulcer* ; Epithelial Cells ; Epithelium, Corneal* ; Extracellular Space ; Hemidesmosomes ; Humans ; Keratitis ; Pathology ; Sensation ; Trigeminal Nerve

OBJECTIVE: To assess the lower tear meniscus height (LTMH), central tear film thickness (CTFT), and central corneal epithelial thickness (CCET) after deep anterior lamellar keratoplasty (DALK). METHODS: This was a retrospective cross-sectional study of 20 patients who had DALK in one eye over a three-month period. LTMH, CTFT, and CCET of the operated eyes and the unoperated fellow eyes were measured using high-definition optical coherence tomography (HD-OCT). Correlations between three OCT assessments and age, time following surgery, graft size, bed size, and the number of residual sutures were analyzed. RESULTS: Compared to patients with keratoconus, patients with other corneal conditions had significantly higher CCET in the fellow eye (P=0.024). For all patients, CCET in the operated eye was significantly negatively correlated with the number of residual sutures (R=-0.579, P=0.008), and was significantly positively correlated with time following surgery (R=0.636, P=0.003). In the fellow eye, a significant positive correlation was found between age and CCET (R=0.551, P=0.012), and a significant negative correlation between age and CTFT (R=-0.491, P=0.028). LTMH was found to be significantly correlated between operated and fellow eyes (R=0.554, P=0.011). There was no significant correlation between LTMH and age, bed/graft size, time following surgery, or residual sutures (all possible correlations, P>0.05). CONCLUSIONS Patients with keratoconus tend to have a thinner central corneal epithelium. Corneal epithelium keeps regenerating over time after DALK. DALK did not induce a significant change in tear volume compared with the fellow eye. Postoperative tear function might depend on an individual's general condition, rather than on age, gender, bed/graft size, time following surgery, or residual sutures.
Adult ; Corneal Transplantation ; Cross-Sectional Studies ; Epithelium, Corneal/pathology* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tears ; Tomography, Optical Coherence

PURPOSE: To investigate the relationship between changes of corneal epithelium and subbasal nerves in non-Sjogren dry eye using in vivo confocal microscope (IVCM) and self-reported clinical symptoms. METHODS: The present study included 40 patients with dry eye and 18 healthy control subjects. The dry eye group underwent an evaluation of dry eye symptoms using visual analogue scale (VAS) score and was subdivided into 2 groups; score 0-5 as the low VAS score (LVS) group and score 6 - 10 as the high VAS score (HVS) group. The tear film break-up time, fluorescein staining, Schirmer test and microstructural imaging of epithelium, and subbasal nerve at cornea center with IVCM were performed on both eyes of each patient. Twenty-three normal eyes and 54 eyes of dry eye patients were included in the study. Cell densities and morphological characteristics were analyzed using ImageJ and NeuronJ softwares. RESULTS: Both LVS and HVS groups had decreased cell density of superficial, intermediate, and basal epithelium (p < 0.001). Intermediate epithelial cells were more decreased in the dry eye group with more severe symptoms (p < 0.0001). Subbasal nerve density (p < 0.005) was more decreased and nerve beadings, tortuosity, and reflectivity increased in the HVS group than both LVS and control groups (p < 0.05). CONCLUSIONS: The alterations of corneal cellular level in dry eye patients visualized using IVCM are correlated with pathology and clinical symptoms and may be useful objective criteria in diagnosis and monitoring treatment efficacy.
Cell Count ; Cornea ; Diagnosis ; Epithelial Cells ; Epithelium ; Epithelium, Corneal ; Fluorescein ; Humans ; Microscopy, Confocal* ; Pathology ; Tears ; Treatment Outcome

The purpose of this study is to demonstrate a method of how to remove epithelium grown beneath the hinge area after laser in situ keratomileusis (LASIK) without affecting the refractive part of the lenticule. In three cases, an incision was made at the base of the hinge by RK diamond knife to free the lenticule from the stroma. The lenticule was lifted from the nasal edge. The epithelium grown along the interface beneath the hinge area was removed with a Bard-Parker No. 15 knife. The lenticular flap was repositioned with interrupted sutures using 10-0 nylon. No further epithelial ingrowth was observed. The central cornea remained clear leaving a peripheral ring-shaped opacity without affecting the preoperative naked visual acuity. In conclusion, epithelial ingrowth along the interface after LASIK can be removed safely without affecting the refractive part by the incision of the hinge area with a RK diamond knife, removal of the epithelium, and suturing of the lenticule to the stromal bed.
Adult ; Epithelium, Corneal/surgery* ; Epithelium, Corneal/pathology* ; Female ; Human ; Keratectomy, Photorefractive, Excimer Laser/adverse effects* ; Male ; Reoperation ; Suture Techniques ; Treatment Outcome ; Visual Acuity/physiology

This study was performed to investigate the changes of tear film and ocular surface in diabetic patients, as well as the ocular and systemic factors related to these changes. We assessed the scoring of keratoepitheliopathy, corneal sensitivity test, tear film break-up time (BUT), Schirmer test, and conjunctival impression cytology in 94 eyes of 47 patients with noninsulin-dependent diabetes mellitus and in 60 eyes of 30 normal subjects. The degree of keratoepitheliopathy was severe, and the corneal sensitivity, BUT, and tear secretion were significantly reduced in the diabetic patients. Conjunctival impression cytology showed a higher grade of conjunctival squamous metaplasia and lower goblet cell density in the diabetic patients. All parameters were related to the status of metabolic control, diabetic neuropathy, and stage of diabetic retinopathy. We think that diabetic patients with poor metabolic control, neuropathy, and advanced stage of retinopathy should be examined for tear film and ocular surface changes.
Adult ; Aged ; Comparative Study ; Corneal Diseases/etiology/*metabolism ; Diabetes Complications/*metabolism/pathology ; Epithelium, Corneal/*metabolism/pathology ; Female ; Goblet Cells/pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Tears/*metabolism

PURPOSE: To use impression cytology to examine the structural changes in corneal epithelial cells infected with the herpes simplex virus in rabbit eyes. METHODS: Corneal surfaces of 7 rabbits were scratched using a 25-gauge needle. Herpes simplex virus (type 1, Kos strain) was inoculated to the injured cornea. As the corneal diseases were observed using slit lamp biomicroscopy, impression cytology was performed for 18 days after inoculation. Specimens were stained with hematoxylin-eosin and examined using optical microscopy. RESULTS: Corneal lesions consisted mainly of round epithelial cells, inflammatory cells, ballooning cells, multinucleated giant cells, and various inclusion bodies. Over time, the corneal epithelial cells peeled away as a result of corneal edema in the corneal lesions. Dendritic lesions were also observed. In the recovery phase, the number of detached cells and infiltrated inflammatory cells decreased. CONCLUSIONS: It was presumed that dendritic lesions might have been formed at the scratched cornea region, thereby aggravating the epithelial cells falling off as a result of the infiltration of inflammatory cells. These cytopathologic effects occur in experimental herpes simplex keratitis.
Animals ; Cercopithecus aethiops ; Cornea/*pathology ; Cytological Techniques ; Epithelium, Corneal/pathology ; Keratitis, Herpetic/*pathology ; Rabbits ; Time Factors ; Vero Cells