Lang G K, Green W R, Maumenee A E
Am J Ophthalmol. 1986 Jan 15;101(1):28-40. doi: 10.1016/0002-9394(86)90461-7.
Thirty eyes of 25 patients who had undergone penetrating keratoplasties were examined post mortem. Available corneal buttons and donor rims were evaluated for irregularities of the trephine margins. Of 26 eyes with clear grafts, visual acuity had been 20/80 or better in 13, worse than 20/100 in six, and was unknown in seven. In four eyes with cloudy grafts, visual acuity had been 20/400 or worse. Twenty-three eyes had had one keratoplasty and seven eyes had had two or three transplants. Microscopic examination disclosed frequent overriding wound edges with Bowman's layer incarceration in the wound in 11 eyes and Descemet's membrane incarceration in 22 eyes. Wound abnormalities were correlated with the presence and degree of astigmatism. A retrocorneal fibrous tissue layer was localized at the wound in 16 eyes, extended peripherally in 11, and extended centrally in one. Iris and vitreous incarceration in the wound occurred in 14 and eight eyes, respectively. Histopathologic features contributing to visual loss included cystoid macular edema (three eyes), senile macular degeneration (four eyes), and preretinal membranes (four eyes).
对25例接受穿透性角膜移植术患者的30只眼进行了尸检。对可用的角膜植片和供体边缘进行评估，检查环钻边缘是否有不规则情况。在26只移植片透明的眼中，13只眼的视力为20/80或更好，6只眼的视力低于20/100，7只眼的视力情况未知。在4只移植片混浊的眼中，视力为20/400或更差。23只眼接受过一次角膜移植，7只眼接受过两次或三次移植。显微镜检查发现，11只眼中有频繁的伤口边缘重叠，伴有Bowman层嵌入伤口，22只眼中有Descemet膜嵌入。伤口异常与散光的存在和程度相关。16只眼中在伤口处发现后弹力层纤维组织层，11只眼中该组织层向周边延伸，1只眼中向中央延伸。伤口处虹膜和玻璃体嵌入分别发生在14只眼和8只眼中。导致视力丧失的组织病理学特征包括黄斑囊样水肿（3只眼）、老年性黄斑变性（4只眼）和视网膜前膜（4只眼）。
