Publication: Alteration in epithelium and stroma of post-INTACS cornea: Ultrastructure and 3D transmission electron tomography
Authors
Omar Kirat2 ; Adrian Smedowski ; Aljohara Alkanaan ; Fahad Almoqbel ; Turki Almubrad ; Saeed Akhtar
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Publisher
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Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-998
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info:eu-repo/semantics/article
Description
Abstract
This study was conducted to investigate the
ultrastructure of the epithelium and stroma of post
INTACS corneas. INTACS were surgically inserted into
the corneas of three patients to remodel the keratoconus
shape. INTACS were inserted with the IntraLase
femtosecond laser. Patients 1, 2, and 3 returned to the
clinic 8, 6, and 9 years, respectively, after surgery due to
their deteriorating vision. The lamellae above the
INTACS were removed surgically and processed for
light and electron microscopy. 2D and 3D digital images
of lamellae, collagen fibrils (CFs), and proteoglycans
(PGs) were captured by a bottom-mounted camera and
analysed using iTEM software. The epithelium and
stromal lamellae had degenerated. A large number of
aggregates of microfilaments were present in the
Bowman’s layer (BW) and throughout the stroma. In the
stroma, just above the INTACS insertion, lamellae were
completely disorganised and running randomly in the
large electron-lucent spaces. The CF diameter was
significantly smaller than in the normal cornea. 3D
images showed microfibrils within the CF were less in
the post-INTACS cornea than in the normal cornea. We
believe that insertion of the INTACS disturbed the
lamellar organisation and uniform distribution of CFs.
This non-uniform CF distribution increased over time,
resulting in vision impairment.
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