[The causes of necrobiosis and apoptosis of corneal epithelial cells during primary acquired keratoconus].

We studied 56 biopsy samples of conjunctiva and 50 corneal discs excised from 28 patients with acquired keratoconus cornea. The conjunctivas in all biopsy samples showed various stages of immune inflammation. Necrobiotic changes have been revealed in epithelium of the corneal discs going by the pathways of apoptosis--programmed cell death--and oncosis--initial edematic stage of necrobiosis. At the stage of acute inflammation they are due to cytotoxic effect of the lymphocytes, monocytes, and macrophages. Antibody-dependent cytotoxicity mediated by plasma and lymphoid cells predominates at this stage. At the reparative stage of inflammation ischemia, an inductor of apoptosis and oncosis, underlies necrobiotic changes in corneal epithelium.