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The normal and abnormal human corneal epithelial surface: a scanning electron microscope study

R R Pfister, N L Burstein

    Investigative Ophthalmology & Visual Science
    |July 1, 1977
    PubMed
    Summary
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    Corneal surface morphology differs by disease. Keratoconus shows blebs, edema causes irregular surfaces, and herpetic keratitis reveals detached cells.

    Area of Science:

    • Ophthalmology
    • Cell Biology
    • Materials Science

    Background:

    • The corneal epithelium's surface morphology is crucial for maintaining ocular surface homeostasis.
    • Understanding disease-specific changes in corneal surface ultrastructure can aid diagnosis and treatment.

    Purpose of the Study:

    • To characterize and differentiate the surface morphology of corneal buttons from various disease processes.
    • To identify unique ultrastructural markers associated with specific corneal pathologies.

    Main Methods:

    • Scanning electron microscopy was used to examine the surface morphology of 108 corneal buttons.
    • Corneal buttons were obtained from patients undergoing keratoplasty for conditions including trauma, keratoconus, corneal edema, and herpetic keratitis.

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    Main Results:

    • Traumatically scarred corneas exhibited normal microvilli and microplicae patterns.
    • Keratoconus specimens displayed characteristic surface blebs, varying in size and distribution based on cone type (nipple vs. sagging).
    • Corneal epithelial edema resulted in large, irregular surfaces with bulging and detached cells, while herpetic keratitis showed loosely attached and edematous epithelial cells.

    Conclusions:

    • Distinct surface morphological patterns are associated with specific corneal diseases.
    • Surface ultrastructural analysis of corneal buttons can provide valuable diagnostic insights.
    • Further research into the composition of blebs in keratoconus may reveal underlying pathomechanisms.