Epithelial and fibrous downgrowth: mechanisms of disease

Chen, Sherleen; Pineda, Roberto

doi:10.1016/s0896-1549(01)00013-x

Cited by 44 publications

(44 citation statements)

References 66 publications

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“…Autoimmune or inflammatory disease, which was present in 3 of the 4 previous patients with reported epithelial downgrowth, can promote intense vascularization of the retrocorneal stromal membrane that in turn can lend support to an epithelial downgrowth. [12][13][14][15][16] Therefore, both stromal and epithelial anterior chamber invasion can develop together. None of our patients had systemic or local inflammatory conditions but were instead treated for developmental abnormalities or neurotrophic scarred corneas.…”

Section: Commentmentioning

confidence: 99%

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Stacy¹

2011

Arch Ophthalmol

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To evaluate retroprosthetic membranes that can occur in 25% to 65% of patients with the Boston type 1 keratoprosthesis (KPro).Methods: Two patients with Peter anomaly and 2 with neurotrophic scarred corneas underwent revisions of their type 1 KPros because of visually compromising retroprosthetic membranes. The excised membranes were studied by light microscopy with hematoxylin-eosin, periodic acid-Schiff, and toluidine blue stains. Immunohistochemical and transmission electron microscopic examination were also used.Results: Light microscopic examination revealed that the retro-KPro fibrous membranes originated from the host's corneal stroma. These mildly to moderately vascularized membranes grew through gaps in the Descemet membrane to reach behind the KPro back plate and adhere to the anterior iris surface, which had undergone partial lysis. In 2 cases, the fibrous membranes merged at the pupil with matrical portions of metaplastic lens epithelium, forming a bilayered structure that crossed the optical axis. Retro-KPro membranes stained positively for ␣-smooth muscle actin but negatively for pancytokeratin. Electron microscopy confirmed the presence of actin filaments within myofibroblasts and small surviving clusters of metaplastic lens epithelial cells.Conclusions: Stromal downgrowth, rather than epithelial downgrowth, was the major element of the retro-KPro membranes in this series. Metaplastic lens epithelium also contributed to opacification of the visual axis. Florid membranous inflammation was not a prominent finding and thus probably not a requisite stimulus for membrane development. Further advances in prosthetic design and newer antifibroproliferative agents may reduce membrane formation.

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Section: Commentmentioning

confidence: 99%

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Stacy¹

2011

Arch Ophthalmol

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“…10,11 Retrocorneal membranes generated by the endothelium are slightly less frequent (9/28) than keratocytic stroma-derived membranes. 5 When the cornea is injured, the wound-healing process in the corneal endothelium seems to consist of 2 distinct pathways: (1) the regenerative pathway, by which endothelial cells are replaced by migration, enlarging, and spreading of the existing endothelial cells; and (2) the nonregenerative pathway (or fibrosis), by which transformed endothelial cells not only resume proliferation but also alter their morphology and collagen phenotypes, leading to the production of an abnormal fibrillar extracellular matrix.…”

Section: Discussionmentioning

confidence: 99%

Retrocorneal Membrane After Descemet Membrane Endothelial Keratoplasty

Yum

Kim²,

Kim³

2013

Cornea

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“…The late stage appears clinically as a homogenous white mass, which comprises clumps containing amorphous materials with scarce cellular elements or cellular debris, suggesting less proliferation [25]. In more severe cases, epithelial ingrowth may extend from the interface to a retrocorneal membrane with extension onto the iris surfaces, causing ectropion uveae, corneal decompensation, and glaucoma [18, 21]. However, not every case of suspected epithelial implantation leads to graft failure, and interface epithelial inclusions can remain static or even regress over time [8, 13, 16, 18, 19, 26].…”

Section: Etiopathogenesis Risk Factors and Mechanismmentioning

confidence: 99%

“…Historically, epithelial ingrowth was described as an anterior chamber growth that rarely occurs after cataract extraction [20], penetrating keratoplasty (PKP) or other invasive ocular surgeries such as anterior chamber aspiration and glaucoma procedures [21]. In the recent literature, the most common experience with epithelial ingrowth into a lamellar interface follows laser in situ keratomileusis (LASIK).…”

Section: Introductionmentioning

confidence: 99%

Etiopathogenesis and Therapy of Epithelial Ingrowth after Descemet’s Stripping Automated Endothelial Keratoplasty

Semeraro

Salvatore

Bova

et al. 2014

BioMed Research International

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Descemet's stripping endothelial keratoplasty is an emerging technique finalized to treat endothelial dysfunction replacing only the pathological portion of cornea. The advent of any new technique puts us in front of new complications. The epithelial ingrowth is a well-known complication already studied in case of ocular trauma and more recently in refractive surgery. This job analyzed the potential etiopathogenesis of epithelial ingrowth after DSAEK, reviewing the cases described in literature, and suggests the potential therapy.

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Epithelial and fibrous downgrowth: mechanisms of disease

Cited by 44 publications

References 66 publications

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Characterization of Retrokeratoprosthetic Membranes in the Boston Type 1 Keratoprosthesis

Retrocorneal Membrane After Descemet Membrane Endothelial Keratoplasty

Etiopathogenesis and Therapy of Epithelial Ingrowth after Descemet’s Stripping Automated Endothelial Keratoplasty

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