Koenig S B, McDonald M B, Yamaguchi T, Friedlander M, Ishii Y
Arch Ophthalmol. 1983 Dec;101(12):1862-5. doi: 10.1001/archopht.1983.01040020864004.
Twenty-three of 55 patients who underwent refractive keratoplasty for the correction of aphakia were found to have a pigmented corneal epithelial line similar to the Fleischer ring. In 21 of 23 cases, the pigmented ring was adjacent to the superficial keratectomy scar that resulted from the keratorefractive operation. In two cases, the pigmented line was located central to the lamellar keratectomy scar. Histopathologic study demonstrated that the line was due to iron in the form of ferritin particles deposited within basal corneal epithelial cells. We believe that the steep anterior corneal curvature (average, 51.45 diopters) and changes in corneal topography at or central to the margin of the lamellar keratoplasty may lead to malapposition of the eyelid to the cornea and cause disturbances in the precorneal tear film. Iron from the tears may then be deposited in the corneal epithelium in areas of tear pooling.
55例接受屈光性角膜移植术矫正无晶状体眼的患者中，有23例被发现有一条类似于Fleischer环的色素沉着角膜上皮线。在23例中的21例中，色素沉着环与角膜屈光手术导致的浅层角膜切除术瘢痕相邻。在2例中，色素沉着线位于板层角膜切除术瘢痕的中央。组织病理学研究表明，这条线是由于铁以铁蛋白颗粒的形式沉积在角膜基底上皮细胞内所致。我们认为，陡峭的角膜前表面曲率（平均51.45屈光度）以及板层角膜移植边缘处或中央的角膜地形图变化，可能导致眼睑与角膜贴合不良，并引起角膜前泪膜紊乱。然后，泪液中的铁可能会在泪液积聚区域的角膜上皮中沉积。
