Posterior corneal pigmentation and fibrous proliferation by iris melanocytes

Pigmentation of the posterior corneal surface results either from endothelial phagocytosis of free melanin pigment or from the presence of iris melanocytes, iris pigment epithelial cells, or pigment-containing macrophages on the posterior corneal surface. Although this is occasionally seen clinically, it is more often noted at histopathologic evaluation after operative or accidental ocular trauma. Three cases of posterior corneal pigmentation by iris melanocytes are reported. In one case, the pigmented membrane was the major cause of considerable visual impairment and was documented with clinical photographs and specular microscopy. By light and electron microscopy, all three cases were consistent with findings of posterior corneal pigmentation by iris stromal melanocytes that had acquired endothelium-like morphologic characteristics. We also consider the possible contribution of these melanocytes to posterior collagen layers of the cornea.