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

To evaluate the ultrastructure of cornea keratocyte infected by Herpes simplex virus, the cornea was excised from enucleated rabbit eyes. Cornea epithelium and endothelium of these was removed and cultivated in culture media. After 7 days, the Kos strain of Herpes simplex virus was inoculated into the cultured cornea keratocytes and co-cultivated until the cytopathic effect occurred. Cornea keratocytes was fixed in the 3%glutaraldehyde and examined with electron microscope. The infected cells were active cells and slightly more round appearance than normal cells. They had microvillies composed of cytoplasmic process protru-sions into collagen fibers. Virus particles was transmitted into neighboring cells easily since there was no barrier function of collagen fibers that was destroyed in the condition of culture. The nuclear changes of infected cells were marked :nuclear chromatin was degraded, condensated and displaced toward the nuclear membrane. There were many virus particles in the nucleus. There were also many degenerations in the cytoplasm, destructed numerous cytoplasmic organelles and many virus particles seen in the cytoplasm. The ultrastructural findings of keratocytes co-cultivated with Herpes simplex virus were identified from our result.
Chromatin ; Collagen ; Cornea ; Culture Media ; Cytoplasm ; Endothelium ; Epithelium ; Herpes Simplex* ; Microvilli ; Nuclear Envelope ; Organelles ; Simplexvirus* ; Virion

No abstract available.
Keratomileusis, Laser In Situ*

PURPOSE: To compare central keratometric values (K-values) measured at the pupillary center by Orbscan II (R) topography (Orbtek, Bausch & Lomb, USA) with preexisting methods for K-values in patients who have been treated with laser in situ keratomileusis (LASIK). METHODS: A total of 36 consecutive eyes of 25 patients who were treated with LASIK for myopia have been followed up for more than 1 year. Central K-values measured by Orbscan II(R) topography, K-values measured with autorefractokeratometer, and refraction-derived K-values were compared . RESULTS: The mean central keratometric K-value measured by Orbscan II (R) topography was 39.65+/-1.94 (35.82 to 43.45) diopter (D), and was not statistically significantly different from the mean refraction derived K-value which was 39.63+/-1.95 D (35.95 to 43.41) (p>0.05), but was statistically lower than the mean K-value measured with autorefractokeratometer which was 40.23+/-1.76 D (36.56 to 43.69) (P<0.05). CONCLUSIONS: In patients who have been treated with LASIK for myopia, central keratometric K-value measured with Orbscan II R topography is not statistically significantly different from refraction derived K-value, but is lower than K-value measured with autorefractokeratometer.
Humans ; Keratomileusis, Laser In Situ* ; Myopia

The purpose of this study is to evaluate the changes of central corneal thickness and axial length after laser-assisted in situ keratomileusis (LASIK) surgery for myopia. 101 eyes of 53 patients who underwent laser in-situ keratomileusis (LASIK) were included in this study.Routine examinations were done in all cases. Central corneal thickness, axial length, keratometry, and refractive error were measured preoperatively and on the 6 month post-operatively. Mean preoperative spherical equivalent was -5.52 D (SD, 1.98 D).Preoperative and postoperative mean central corneal thickness was 530.64 micrometer (SD, 27.62 micrometer)and 468.84 micrometer (SD, 33.32 micrometer).Preoperative and postoperative keratometry was 43.69 D (SD, 1.90 D)and 39.12 D (SD, 1.98 D).Preoperative and postoperative average axial length was 25.56 mm (SD, 1.05 mm)and 25.51 mm (SD, 1.08 mm).When postoperative measurements were compared with preoperative measurements, there was a significant decrease in central corneal thickness (t=25.68, p=0.000)and keratometry (t=23.61, p=0.000), but there was no significant difference in axial length (t=1.82, p=0.072). Refractive changes related to axial length measurements changes on the 6 month after LASIK are not important compared with the total refractive corrections of LASIK.
Follow-Up Studies* ; Humans ; Keratomileusis, Laser In Situ* ; Myopia* ; Refractive Errors

PURPOSE: To report a previously unreported secondary Mooren's ulcer associated with simultaneous sur-gery for cataract and pterygium. METHODS: Case report. Five days after simultaneous surgery for cataract and pterygium, an 86-year-old woman developed severe pain and a superior and inferior peripheral corneal ulcer that had the characteristic clinical appearance of Mooren's ulcer. RESULTS: Peripheral corneal ulcer is rapidly progressive, painful, beginning at the limbus with a gray, overhanging, infiltrated edge at its central border. She had no history of collagen-vascular disease, negative serologic test result, and negative culture for pathogen. Surgical trauma may have been the inciting factor in development of the ulcer. She was treated with topical and systemic steroids. After complete control of the inflammation, the patient remained in remission.
Aged, 80 and over ; Cataract* ; Corneal Ulcer* ; Female ; Humans ; Inflammation ; Pterygium* ; Serologic Tests ; Steroids ; Ulcer*

No abstract available.
Epinephrine* ; Injections, Subcutaneous* ; Lidocaine* ; Ophthalmic Artery*

Type VII collagen is one of the major structural components of the corneal epithelial adhesion complex. Using the immunogold technique combined with indirect immunofluorescence analysis, the fine structural distribution of type VII collagen was studied in the corneas obtained from 5 enucleated hyman eyes (age range, 1-77 years) including one pathologic cornea from graft rejection. The findings on normal cornea corroborated the results from previous studies. In pathologic cornea from graft rejection, type VII collagen antibodies generated linear and irregular patchy fluorescence staining along the epithelial-stromal interface and immunogold binding to type VII collagen mainly occurred within the undulating lamina densa, more densealy distributed anchoring plaques and anchoring fibrils. The distribution of type VII collagen in pathologic human cornea from graft rejection is similar to normal human cornea. But, in pathologic cornea, type VII collagen is more densely distributed in superficial stroma and forms more extended anchoring network, which may be derived from the increased secretion of the type VII collagen due to the activated basal epithelial cell during healing process.
Antibodies ; Collagen Type VII* ; Cornea* ; Epithelial Cells ; Fluorescence ; Fluorescent Antibody Technique, Indirect ; Graft Rejection ; Humans ; Immunohistochemistry

The purpose of this study is to compare, by statistical analysis, intraocular lens (IOL) powers by SRK/T formula using autorefractokeratometer-measured keratometric (K) values (SRK/T-ARK-mK), by SRK/T formula using refraction-derived K values (SRK/T-R-dK), and by refraction corrected method (RCM), in eyes treated with photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for myopia. Thirty-eight consecutive eyes of 23 patients with PRK for mild to moderate myopia and 35 consecutive eyes of 25 patients with LASIK for high myopia were followed up for more than 1 year. In the two groups, IOL powers by SRK/T-ARK-mK, by SRK/T-R-dK, and by RCM were compared by statistical analysis. In PRK group, the mean value of IOL powers by RCM was statistically higher than that obtained by the other two methods (p < 0.05), while there was no significant statistical difference between the mean values of IOL powers by SRK/T-ARK-mK and by SRK/T-R-dK (p > 0.05). However, in LASIK group, the mean values of IOL powers by RCM and by SRK/T-R-dK, which did not differ statistically (p > 0.05), were both statistically higher than that by SRK/T-ARK-mK (p < 0.05). In conclusion, there is a statistical difference in IOL powers by the methods used for IOL calculation, as there is according to the level of myopia in patients with PRK and LASIK treatment. We suggest that, in IOL power calculation in eyes with previous corneal refractive surgery, correction methods such as RCM and SRK/T-R-dK are more effective at higher levels of myopia.
Adult ; Comparative Study ; Cornea/surgery ; Female ; Human ; *Keratectomy, Photorefractive, Excimer Laser ; *Keratomileusis, Laser In Situ ; *Lenses, Intraocular ; Male ; Myopia/surgery ; *Optics ; Postoperative Period ; Prospective Studies