Brooks A M, Grant G, Gillies W E
Aust N Z J Ophthalmol. 1986 May;14(2):171-5. doi: 10.1111/j.1442-9071.1986.tb00030.x.
A series of five cases is described in which superficial punctate keratopathy was associated with endothelial cell changes. The most striking change was the presence of dark areas or blebs, usually two to four cell diameters in extent. There was also distortion and crumpling of the corneal endothelium, mild pleomorphism and polymegathism of the endothelial cells, with a reduced cell count in some cases. These blebs have previously been reported in hard and soft contact lens wearers and are due to intercellular oedema with separation of endothelial cells from Descemet's membrane. Anoxia and interference with osmosis have been proposed as possible mechanisms for the production of these blebs, but our cases demonstrate that fine disruption of the corneal epithelium can affect the integrity of the corneal endothelium and may lead to significant damage over a long period of time.
本文描述了5例浅表点状角膜病变伴有内皮细胞改变的病例。最显著的变化是出现暗区或小泡，范围通常为两到四个细胞直径。角膜内皮还存在扭曲和皱缩，内皮细胞有轻度的异形性和大小不均，部分病例细胞计数减少。这些小泡先前在硬性和软性隐形眼镜佩戴者中已有报道，是由于细胞间水肿导致内皮细胞与后弹力层分离所致。有人提出缺氧和渗透干扰可能是产生这些小泡的机制，但我们的病例表明，角膜上皮的细微破坏可影响角膜内皮的完整性，并可能在长时间内导致严重损害。
