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Paul S. Koch, MD; Frederick A. Jakobiec, MD; Takeo Iwamoto, MD; Richard C. Troutman, MD; Casimir A. Swinger, MD

Arch Ophthalmol. 1981;99(9):1634-1639.

Abstract
• Three patients experienced technical failures from their keratophakia procedures, and their lenticles were removed at intervals of three days, 2 months, and nine months, respectively, postoperatively. All three lenticles displayed, by both light and electron microscopy, degeneration of their keratocytes without any evidence of repopulation by the host's keratocytes. Small increases in amorphous material were noted between the collagen fibrils, but the stromal lamellae were otherwise well preserved and oriented. There was no clear evidence of new collagen production at the edges of the lenticles. One failure was caused by the mistaken inclusion of Descemet's membrane in the lenticle. Another specimen with epithelial ingrowth also displayed degeneration of the collagen fibrils along one edge; this degeneration was possibly the result of collagenase activity.

Author Affiliations
From the Department of Ophthalmology, The New York Hospital-Cornell Medical Center (Drs Koch, Jakobiec, Iwamoto, Troutman, and Swinger); the Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York (Drs Koch, Jakobiec, Iwamoto, Troutman, and Swinger); the Department of Ophthalmology, Beth Israel Medical Center, New York (Dr Swinger); and the Eye Bank for Sight Restoration, New York (Dr Jakobiec).

Footnotes
Accepted for publication Nov 24, 1980.

Reprint requests to Manhattan Eye, Ear, and Throat Hospital, 210 E 64th St, New York, NY 10021 (Dr Jakobiec).

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