Ocular Surface Center Berlin, Department for Cell and Neurobiology, Center for Anatomy, Charité- Universitätsmedizin Berlin, Berlin, Germany.
J Anat. 2011 Apr;218(4):449-61. doi: 10.1111/j.1469-7580.2011.01355.x.
The inner border of the eyelid margin is critically important for ocular surface integrity because it guarantees the thin spread of the tear film. Its exact morphology in the human is still insufficiently known. The histology in serial sections of upper and lower lid margins in whole-mount specimens from 10 human body donors was compared to in vivo confocal microscopy of eight eyes with a Heidelberg retina-tomograph (HRT II) and attached Rostock cornea module. Behind the posterior margin of the Meibomian orifices, the cornified epidermis stopped abruptly and was replaced by a continuous layer of para-keratinized (pk) cells followed by discontinuous pk cells. The pk cells covered the muco-cutaneous junction (MCJ), the surface of which corresponded to the line of Marx (0.2-0.3 mm wide). Then a stratified epithelium with a conjunctival structure of cuboidal cells, some pk cells, and goblet cells formed an epithelial elevation of typically about 100 μm initial thickness (lid wiper). This continued for 0.3-1.5 mm and formed a slope. The MCJ and lid wiper extended all along the lid margin from nasal to temporal positions in the upper and lower lids. Details of the epithelium and connective tissue were also detectable using the Rostock cornea module. The human inner lid border has distinct zones. Due to its location and morphology, the epithelial lip of the lid wiper appears a suitable structure to spread the tear film and is distinct from the MCJ/line of Marx. Better knowledge of the lid margin appears important for understanding dry eye disease and its morphology can be analysed clinically by in vivo confocal microscopy.
眼睑缘的内边界对于眼表面完整性至关重要，因为它保证了泪膜的薄铺展。其在人类中的确切形态仍知之甚少。通过对 10 名尸体供体的全距标本的上、下眼睑缘的连续切片组织学与 8 只眼的活体共聚焦显微镜（海德堡视网膜断层扫描仪[HRT II]和附加的罗斯托克角膜模块）进行比较。在睑板腺开口的后缘后面，角化表皮突然停止，被连续的层状副角蛋白（pk）细胞取代，然后是不连续的 pk 细胞。pk 细胞覆盖粘-皮交界处（MCJ），其表面与 Marx 线（0.2-0.3mm 宽）相对应。然后，具有立方细胞、一些 pk 细胞和杯状细胞的结膜结构的复层上皮形成上皮隆起，通常初始厚度约为 100μm（眼睑擦拭器）。该隆起持续 0.3-1.5mm 并形成一个斜坡。MCJ 和眼睑擦拭器在上、下眼睑中从鼻侧到颞侧位置沿着整个眼睑缘延伸。使用罗斯托克角膜模块还可以检测到上皮和结缔组织的详细信息。人类内眼睑边界有明显的区域。由于其位置和形态，眼睑擦拭器的上皮唇似乎是一个适合铺展泪膜的结构，并且与 MCJ/Marx 线不同。更好地了解眼睑边缘对于理解干眼症及其形态学非常重要，并且可以通过活体共聚焦显微镜进行临床分析。
