Abstract
Purpose: To present the morphological study of transmission electronic microscope (TEM) and the immunohistochemical staining of matrix metalloproteinases (MMPs) of a blood stained cornea. Method: Case report. Result: A 71-year-old male was referred to our department because of traumatic hyphema complicated with glaucoma of his left eye. Corneal blood staining with corneal edema developed despite treating with topical corticosteroids and anti-glaucoma agents. Under the impression of corneal hemosiderosis, he received penetrating keratoplasty seven months later and the excised corneal button was sent for light microscope, TEM and immunohistochemical studies. The finding of TEM, showing electron-dense material observed extracellularly between collagen fibrils and within the cytoplasm of keratocytes, was similar to the light microscope. Immunohistochemical stain revealed positively staining of the active form of MMP-9 in the epithelium and anterior stroma, which was not present in normal cornea. Conclusion: The erythrocyte breakdown products in the cornea may activate the expression of MMP-9, which may be responsible for the thinning of the blood stained cornea.
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