AbstractPurpose: More eyes with keratoconus (KC) require keratoplasty after hydrops when compared to those after haab striae in primary congenital glaucoma (PCG). To compare descemet's membrane (DM) tear morphology in KC and PCG eyes using ASOCT and histopathology.Methods: ASOCT of KC eyes with hydrops (n = 12) and PCG eyes with Haab's striae (n = 15) were evaluated and compared with healthy eyes (n = 14) for descemet's membrane/ pre‐descemet's layer (DM‐PDL) morphology. These features were also assessed on histopathology of corneal button obtained from KC eyes (n = 14) and PCG (n = 13) after keratoplasty and compared with control tissues (retinoblastoma not involving cornea, n = 6) on light microscopy and immunostaining.Results: ASOCT showed thinner DM‐PDL in KC eyes(47.1 ± 25.5 μ) than that of PCG (77.2 ± 26.2 μ) (p = 0.01) inside areas of healed hydrops/ Haab's striae. DM‐PDL detachment was seen in 90% of KC eyes and 26% of PCG eyes. The height and angle of DM‐PDL detachment of KC eyes was more than that of PCG eyes. Similar to ASOCT findings, histopathology showed thinner DM‐PDL in KC eyes (62.6 ± 57.3 μ) compared to PCG (80.3 ± 78.7 μ) inside areas of healed hydrops/ Haab's striae but thicker than that of controls (32.6 ± 7.8 μ) (p‐0.01).Conclusions: Lesser fibroproliferative response and greater height of detachment ensure a poor healing after acute DM/ PDL tears in KC. This differential response of the posterior cornea may be responsible for greater need for keratoplasty in KC versus in PCG.
Read full abstract