Abstract
Abstract: :
Purpose: To investigate the ultrastructural changes occuring in removed cultivated corneal epithelium transplants by using scanning and transmission electron microscopy. Methods: Allo-cultivated corneal epithelial transplantation using an amniotic membrane carrier was carried out in three patients. The primary diagnoses of the patients consisted of one with an acute phase chemical burn, one with drug-induced pseudopemphigoid and one with Stevens-Johnson syndrome. After a period of several months the allo-cultivated epithelial transplants on the amniotic membrane carriers were removed due to graft opacities. The removed transplants were prepared for examination by scanning and transmission electron microscopy. Results: All three removed transplants showed a similar pattern of ultrastructual findings. In all three cases the amniotic membrane remained intact, although it had become partially vascularised and invaded by keratocyte-like cells. Numerous inflammatory cells including macrophages, lymphocytes, granulocytes and plasma cells were present in the epithelial layer and within the amniotic membrane. Most of the amniotic membrane was covered by conjunctival epithelial cells and goblet cells. Only a few isolated areas of normal cultivated corneal epithelial cells were found. Conclusion: We suggest that, in all three of these patients, the process of allograft rejection is responsible for the loss of corneal epithelial cells and that this is followed by conjunctival invasion onto the amniotic membrane.
Keywords: 372 cornea: epithelium • 353 clinical (human) or epidemiologic studies: outcomes/complications • 472 microscopy: electron microscopy