[Breaks in Descemet's membrane. Association with secondary warts. Histologic and ultrastructural study].

We analysed the histological and ultrastructural aspects of corneal buttons obtained by keratoplasty in two patients presenting breaks in Descemet's membrane. The edges of the breaks appear clinically as glassy ridges or ledges and are also called Haab's lines. One patient had a birth trauma and the other had congenital glaucoma. The edges of the breaks coiled anteriorly towards the stroma and were dramatically thickened by a multilaminar Descemet's like membrane that exhibited excrescences within its outer part and that was secreted by regenerated endothelial cells. Only one case was analysed by SEM. Secondary guttuta could not be detected by this technique because it was completely covered by a sheet of newly secreted fibrous tissue that prevented the warts from indenting the endothelial cells. The part of cornea corresponding to the break was also covered by a new thick Descemet's like membrane exhibiting guttate warts. This study is thus a good opportunity to discuss the mechanisms of endothelial and Descemet's membrane regeneration.