Tripoli N K, Cohen K L, Proia A D
Department of Ophthalmology, University of North Carolina, Chapel Hill 27599-7040.
Refract Corneal Surg. 1992 May-Jun;8(3):196-203.
A major contributor to postkeratoplasty astigmatism may be donor/recipient disparity. Deficient or excess cornea at the wound is thought to influence the directions of the steep and flat meridians. Using an established model of penetrating keratoplasty in the cat, this study evaluated the morphometry of histopathologic wound features in the steep and flat meridians.
Thirteen cats had successful penetrating keratoplasties after intentionally misshapen donor corneas were misaligned in misshapen recipient beds. At 9.50 +/- 0.32 (mean +/- 1 SEM) months after keratoplasty, photokeratography was performed and analyzed, corneas were sectioned along the steep and flat meridians, and four histologic sections were processed. Features of the wounds were measured using a Zeiss Videoplan. The relationships between the morphometry of each feature and every other feature, between the morphometry of each feature and eccentricity, and between the steep and flat section morphometry of each feature were statistically evaluated.
Epithelial thickness, area of lamellar alteration, length of Descemet's membrane produced postoperatively, and the depth that preoperative Descemet's membrane was embedded in the stroma were correlated with eccentricity (corneal astigmatism). Stromal thickness and the presence or absence of folded and fragmented Descemet's membrane were not correlated with eccentricity. Wound morphometry at the steep meridians was neither correlated with nor significantly different from wound morphometry at the flat meridians.
Differences between healing at the steep and flat meridians were not likely contributors to astigmatism. Disproportionate availability of tissue in wound regions may have affected healing throughout the entire wound over time. The absence of Bowman's layer in cats restricts application of our results to understanding the etiology of corneal astigmatism after penetrating keratoplasty in humans.
