[Changes in the cornea following complicated pseudophakia and subsequent keratoplasty (clinical and scanning electron...

An anterior chamber lens (Binkhorst four-loop lens) became dislocated seven weeks after implantation. It was relocated in the right position by means of a small incision. In the course of the following 8 weeks the cornea opacified from the top downward. A penetrating keratoplasty was performed. Intraoperatively it was found that a strand of vitreous had pushed forward between the iris and the lens and was adhering to the back of the cornea. The piece of cornea removed was prepared for the scanning electron microscope. The microscopic findings are described in detail. They correspond exactly to the clinical diagnosis of complete tearing of the endothelium, considerable bullous changes in the parenchyma and degenerative changes in the epithelium. The scanning electron microscope reveals how severe pathologic changes in the cornea can become if a strand of the vitreous becomes adherent to the endothelium.