The main pathologic findings are summarized in
Table 2 . In 19 of the 20 examined corneas the surface epithelium appeared
normal. In one cornea there was a ridge, where, in the same image
section, both surface and basal epithelial cells of normal size were
visible (image not shown). In 5 corneas there was pleomorphism of the
basal epithelial cells (
Fig. 1A ), and in 13 corneas there were dense deposits between or posterior to
these cells
(Fig. 1B) . The region immediately behind the basal
epithelium was characterized by irregular dark and light patches and
appeared to be opaque in most cases
(Fig. 1C) . In general, the number
of long nerve fiber bundles in most patients was reduced when compared
with control corneas. Only one cornea (in a 30-year-old woman) had a
normal-looking subbasal nerve plexus, with six thick parallel nerve
fiber bundles
(Fig. 1D) , and another one had four thick, unusual,
undulated nerve fiber bundles
(Fig. 1E) . Thirteen corneas showed one to
three long nerve fiber bundles, and five corneas had only short
branches or no main nerve fiber bundles
(Fig. 1F) . Two corneas showed
normal keratocyte appearance in the anterior stroma, whereas in one
cornea the anterior keratocytes were hyperreflective and irregular in
shape (
Fig. 2A ). In the remaining corneas, the anterior parts of the stroma seemed
fibrotic or scarred
(Fig. 2B) , and in five of these corneas dense
hyperreflective scar tissue was observed
(Figs. 2C 2D) . In 15 of 20
corneas thick anterior and midstromal filaments, corresponding to
lattice lines visible on biomicroscopy were observed
(Fig. 2E) . They
were thicker than normal stromal nerves and appeared to be located
between collagen lamellae. In addition, thin, undulated, unspecified
structures were observed in the stroma of 11 corneas
(Figs. 2F 2G) . In
only six corneas were stromal nerves with normal caliber and an oblique
pattern noted
(Fig. 2H) . The endothelium turned out to be normal in 17
corneas and was not visualized at all in one cornea. One cornea showed
small endothelial pits, and another had a precipitate-like aggregation
on the endothelium (images not shown). The total central corneal
thickness varied between 489 and 573 μm (mean value 530 ± 6μ
m).