Corneal decompensation in Chandler's syndrome. A scanning and transmission electron microscopic study
T. M. Richardson
A corneal button obtained from a 58-year-old woman with Chandler's syndrome
was studied by light and electron microscopy. Clinically, the patient had
mild unilateral glaucoma, slight changes in the iris, endothelial
dystrophy, and corneal edema that was increasingly sensitive to intraocular
pressure. Corneal pathology included loss of large numbers of endothelial
cells with consequent exposure of Descemet's membrane. Endothelial cells
demonstrated irregular shape, partial loss of tight junctions, and
increased numbers of cytoplasmic filaments. Some endothelial cells appeared
metaplastic or perhaps were replaced by cells from some source other than
the cornea. Proliferation of cells was not apparent. A thin layer of
acellular tissue, containing long-spacing collagen and 15-nm-wide fibrils,
was interposed between normal Descemet's membrane and the endothelium.
These observations suggest a basis for the corneal edema that distinguishes
Chandler's syndrome from other forms of essential iris atrophy.
