[Morphogenesis of corneal epithelial-endothelial dystrophy (a comparative morphological analysis of corneal disks and biopsy specimens of the conjunctiva)].

The aim of this study was morphological analysis of corneal disks and conjunctival biopsy specimens in order to disclose the mechanisms of development of epithelial-endothelial dystrophy (EED) and validating pathogenetically-based therapy. Twenty-five patients were observed, 11 of these with implanted intraocular lenses of different localization. EED developed for 1 to 5 years. Sixteen biopsy specimens of the conjunctiva and 21 corneal disks were examined. The composition and index of inflammatory infiltrate, status and compactness of conjunctival vessels, severity of fibrosis, and mast cell degranulation were assessed. Mast cells play a positive role at the initial stages of tissue and cellular response to injury by regulating the formation of extracellular matrix and fibroblast proliferation. At the reparative stages of immune inflammation of the conjunctiva, mast cells are virtually the only cell population; fibrosis and sclerosis develop when the capillary bed is reduced, causing ischemic involvement of the anterior segment of the eye and dystrophic processes in the cornea. A differentiated approach to treatment of EED at the stages of immune inflammation and fibrosis is emphasized.