[Histopathological observations on bullous keratopathy after argon-laser iridotomy].

PURPOSE: To elucidate histopathological mechanism of bullous keratopathy after argon-laser iridotomy (ALI).

CASE AND METHOD: The patient was a 60-year-old female who underwent penetrating keratoplasty because of bullous keratopathy after 2 years and 2 months of ALI. The corneal specimen was fixed with a mixture of 2.5% formalin and 1.0% glutaraldehyde, and examined under light and electron microscopes.

FINDING AND

CONCLUSION

Laser-damaged endothelium produced a large amount of basement membrane-like material beneath Descemet's membrane. At the next stage, the severely damaged endothelium lost its organellae and cell membranes, and fell off. The surrounding healthy endothelium migrated into the damaged area and produced a small amount of material like basement membrane which covered Descemet's membrane. After that, stromal swelling, decrease of keratocytes, breaking and disappearance of Bowman's membrane, epithelial edema, connective tissue accumulation beneath basal cells, and epithelial detachment occurred in the laser-damaged area.