Alteration of microfibrils in the conjunctiva of patients with exfoliation syndrome.

We electron-microscopically studied 15 specimens of upper limbal conjunctiva obtained from 14 patients with exfoliation syndrome and clinical evidence of glaucoma. Of 15 specimens, four (three patients) contained exfoliation materials in the stroma of the conjunctiva. These exfoliation materials of immature, intermediate, and mature forms were composed of abnormal microfibrils lying adjacent to the fibroblasts and located in close proximity to the elastic and collagen fibers. These observations suggest a sequence of events by which microfibrils develop into exfoliation materials.