Joshua H Hou1, Kavitha R Sivaraman1, Jose de la Cruz1, Amy Y Lin2, Maria Soledad Cortina1. 1. Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago. 2. Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago2Department of Pathology, University of Illinois at Chicago.
Abstract
IMPORTANCE: Retroprosthetic membrane (RPM) formation is the most common complication associated with the Boston type 1 keratoprosthesis and has been associated with corneal melt. OBJECTIVE: To identify the histological and immunohistochemical characteristics of RPMs associated with corneal melt. DESIGN, SETTING, AND PARTICIPANTS: Observational histopathological case series at a tertiary eye care referral center among patients who underwent Boston type 1 keratoprosthesis explantation because of donor corneal melt at the Illinois Eye and Ear Infirmary between January 1, 2011, and January 1, 2012. EXPOSURES: Seven RPM specimens from 7 eyes were stained with hematoxylin-eosin, cytokeratin 7, cytokeratin AE1/3, smooth muscle actin, vimentin, and CD34. Light microscopy was used to evaluate specimens for inflammation and epithelial ingrowth. XY-karyotyping using fluorescence in situ hybridization was performed on 4 specimens with known donor-recipient sex mismatch. MAIN OUTCOMES AND MEASURES: Histological and immunohistochemical characteristics of RPMs. RESULTS: Inflammatory cells were present in 4 of 7 RPMs. In 3 of 4 sex-mismatched specimens, tissue XY-karyotyping of the RPM interphase cells was consistent with the host sex karyotype. The fourth specimen showed a mixture of recipient-type and donor-type cells. CONCLUSIONS AND RELEVANCE: Melt-associated RPMs show variable degrees of inflammation. Most membranes seem to originate from a proliferation of host cells, but donor tissue may contribute in some cases.
IMPORTANCE: Retroprosthetic membrane (RPM) formation is the most common complication associated with the Boston type 1 keratoprosthesis and has been associated with corneal melt. OBJECTIVE: To identify the histological and immunohistochemical characteristics of RPMs associated with corneal melt. DESIGN, SETTING, AND PARTICIPANTS: Observational histopathological case series at a tertiary eye care referral center among patients who underwent Boston type 1 keratoprosthesis explantation because of donor corneal melt at the Illinois Eye and Ear Infirmary between January 1, 2011, and January 1, 2012. EXPOSURES: Seven RPM specimens from 7 eyes were stained with hematoxylin-eosin, cytokeratin 7, cytokeratin AE1/3, smooth muscle actin, vimentin, and CD34. Light microscopy was used to evaluate specimens for inflammation and epithelial ingrowth. XY-karyotyping using fluorescence in situ hybridization was performed on 4 specimens with known donor-recipient sex mismatch. MAIN OUTCOMES AND MEASURES: Histological and immunohistochemical characteristics of RPMs. RESULTS: Inflammatory cells were present in 4 of 7 RPMs. In 3 of 4 sex-mismatched specimens, tissue XY-karyotyping of the RPM interphase cells was consistent with the host sex karyotype. The fourth specimen showed a mixture of recipient-type and donor-type cells. CONCLUSIONS AND RELEVANCE: Melt-associated RPMs show variable degrees of inflammation. Most membranes seem to originate from a proliferation of host cells, but donor tissue may contribute in some cases.
Authors: Allister Gibbons; Ella H Leung; Luis J Haddock; Carlos A Medina; Viviana Fernandez; Jean-Marie A Parel; Heather A Durkee; Guillermo Amescua; Eduardo C Alfonso; Victor L Perez Journal: Clin Ophthalmol Date: 2018-02-15