Johnson B L, Brown S I
Br J Ophthalmol. 1978 Feb;62(2):89-96. doi: 10.1136/bjo.62.2.89.
Microscopic study of a keratoplasty specimen in a case of posterior polymorphous dystrophy demonstrated via serial sections a multilaminar Descemet's membrane with focal fusiform nodular protrusions of connective tissue. The latter are thought to represent the polymorphous lesions of the posterior limiting layers of the cornea seen clinically. Ultrastructurally, fibroflast-like cells lined the posterior surface of the cornea. It is postulated that those reported cases of PPD in which epithelial-like transformation of the endothelial layer has been described may represent more advanced cases, in which corneal oedema is likely to be a prominant feature clinically. An evolving process of metaplasia rather than a static one might explain the variety of altered endothelial cells, fibroblasts, and epithelial cells which have been reported on the posterior cornea in the few PPD keratoplasty specimens studied to date.
对一例后多形性营养不良角膜移植标本进行显微镜检查，通过连续切片显示Descemet膜多层，伴有结缔组织的局灶性梭形结节状突起。后者被认为代表临床上所见角膜后界层的多形性病变。超微结构上，角膜后表面排列有成纤维细胞样细胞。据推测，那些报道有内皮细胞上皮样化生的后多形性营养不良病例可能代表更晚期病例，临床上角膜水肿可能是一个突出特征。化生的演变过程而非静态过程可能解释了迄今为止在少数后多形性营养不良角膜移植标本中报道的后角膜内皮细胞、成纤维细胞和上皮细胞的各种改变。
