Ultrastructure of Human Lenticles in Keratophakia

Three patients experienced technical failures from their keratophakia procedures and their lenticles were removed at intervals of three days, 2 1/2 months, and nine months, respectively, postoperatively. All three lenticles displayed, by both light and electron microscopy, degeneration of their keratocytes without any evidence of repopulation by the host's keratocytes. Small increases in amorphous material were noted between the collagen fibrils, but the stromal lamellae were otherwise well preserved and oriented. There was not clear evidence of new collagen production at the edges of the lenticles. One failure was caused by the mistaken inclusion of Descemet's membrane in the lenticle. Another specimen with epithelial ingrowth also displayed degeneration of the collagen fibrils along one edge; this degeneration was possibly the result of collagenase activity.