Yeo J H, Jakobiec F A, Pokorny K, Iwamoto T, Pisacano A
Ophthalmology. 1983 Apr;90(4):410-9. doi: 10.1016/s0161-6420(83)34546-2.
A white cocoon membrane emanating from an inferotemporal focus in the iris stroma totally ensheathed a Binkhorst four-loop iris plane lens 18 months after implantation. The membrane was removed and studied by scanning (SEM) and transmission (TEM) electron microscopy. By SEM the external surface of the membrane was characterized by a fibrillar meshwork, with only an occasional scattered spindle-shaped or rounded inflammatory cell occupying the surface. One-micron plastic sections revealed both spindle and polyhedral heavily pigmented cells in the outer aspect of the membrane, and compressed elongated nonpigmented spindle cells scattered throughout the central portions. By TEM cells clinging to the outermost aspects were bipolar iris stromal melanocytes with small melanosomes, inactive fibroblasts, or histiocytes with cytoplasmic ruffles. The larger rounded pigmented cells in the superficial region were viable or degenerated iris pigment epithelial cells or macrophages. Most of the substance of the membrane was composed of collagen fibrils 100-500 A in diameter with and without 640 A periodicity; these fibrils were generally oriented parallel to the spindle cells but did not display distinct bundling or a lamellar architecture. The spindle cells in the center of the lesion were active fibroblasts with abundant rough-surfaced endoplasmic reticulum and scattered actin myofilaments; they contained rare small and large melanin granules indicative of phagocytosis. It has been concluded that the membrane was produced predominantly by iris stromal fibroblasts probably activated by the haptics of the IOL or McCanell suture.
植入18个月后，从虹膜基质颞下象限病灶处发出的白色茧状膜完全包裹了一片Binkhorst四环虹膜平面人工晶状体。取出该膜，通过扫描电子显微镜（SEM）和透射电子显微镜（TEM）进行研究。通过SEM观察，膜的外表面具有纤维状网络结构，仅有偶尔散在的梭形或圆形炎性细胞占据表面。1微米厚的塑料切片显示，膜的外侧既有梭形和多面体的色素沉着严重的细胞，也有散在分布于中央部分的压缩伸长的无色素梭形细胞。通过TEM观察，附着在最外层的细胞为具有小黑素体的双极虹膜基质黑素细胞、不活跃的成纤维细胞或具有胞质褶皱的组织细胞。表层区域较大的圆形色素沉着细胞为存活或退变的虹膜色素上皮细胞或巨噬细胞。膜的大部分物质由直径为100 - 500埃、有或无640埃周期性的胶原纤维组成；这些纤维通常与梭形细胞平行排列，但未显示出明显的束状或层状结构。病灶中心的梭形细胞为活跃的成纤维细胞，具有丰富的糙面内质网和散在的肌动蛋白肌丝；它们含有罕见的大小不一的黑素颗粒，提示存在吞噬作用。得出的结论是，该膜主要由虹膜基质成纤维细胞产生，可能是由人工晶状体的袢或麦卡内尔缝线激活所致。
