Histopathology of Corneal Pathology in
J. N. Ulrich¹; R. C. Eagle²
¹Geisinger Medical Center, Danville, PA
²Wills Eye Institute, Philadelphia, PA
Descemet-stripping with endothelial keratoplasty
(DSEK) has become increasingly popular since its
description by Price & Price in 2005¹. In diseases
limited to the inner cornea (e.g. Fuch’s endothelial
dystrophy (FED), pseudophakic bullous keratopathy
(PBK) ) DSEK represents a valuable alternative to
conventional penetrating keratoplasty. This study
describes the histopathology of Descemet membranes
(DM) obtained by DSEK.
¹Price FW Jr, Price MO. Descemet's stripping with endothelial keratoplasty in
50 eyes: a refractive neutral corneal transplant.
J Refract Surg. 2005 Jul-Aug;21(4):339-45.
110 consecutive corneal specimens from patients
undergoing DSEK for FED and PBK between
January 2006 and April 2007 were processed at the
Department for Ocular Pathology at Wills Eye
Institute, Philadelphia. Specimens were stained with
haematoxylin and eosin (HE) as well as with perodic
acid Schiff's reagent (PAS) and assessed by light
Folded segments of DM without associated stroma
were identified. 76 cases of FED were characterized
by irregularly thickened DM, studded with guttate
excrescences as well as relatively preserved
endothelium with melanin granules. 25 cases of PBK
showed a regular DM and severely atrophic
endothelium. Guttae evidenced underlying
endothelial dystrophy in 9 cases of PBK.
PBK with underlying FED
A- FED B- PBK with underlying FED C- PBK
Histopathologic examination easily provides
diagnostic confirmation of FED and PBK in DSEK
specimens, which should be submitted.