PMC3913986_01
(A) A preoperative anterior segment photograph of the left eye shows a jelly-like corneal degeneration (8.7 x 7 mm). (B,C) Anterior optical tomography (Visante OCT) shows a 1.39-mm full-thickness cornea and a 0.89-mm-deep area of corneal degeneration.
kjo-28-86-g001.jpg
PMC3913986_01_kjo-28-86-g001.jpg
F1
The entire corneal thickness was 1.39 mm, the depth of the degenerated lesion was 0.89 mm, and the residual corneal tissue was 0.50 mm, as measured by anterior optical tomography (Visante optical coherence tomography; Carl Zeiss Meditec, Dublin, CA, USA) (Fig. 1).
(A) A postoperative anterior segment photograph taken 90 days after deep anterior lamellar keratoplasty of the left eye showing a completely healed cornea. (B) Almost corneal epithelial defects had healed by three months after surgery.
kjo-28-86-g002.jpg
PMC3913986_01_kjo-28-86-g002.jpg
F2
One year after treatment, no recurrence was observed (Fig. 2).
The lesion is covered by degenerated squamous epithelium. The underlying stroma shows marked myxoid and vacuolar degeneration, with positive Alcian blue staining. A few fibroblast-like spindle cells are scattered in the degenerated stroma. (A) Hematoxylin and eosin, x40; (B) Alcian blue stain, x40.
kjo-28-86-g003.jpg
PMC3913986_01_kjo-28-86-g003.jpg
F3
The myxoid tissue was positive on Alcian blue staining (pH 2.5), and a few scattered fibroblasts were observed on hematoxylin and eosin (H&E) staining (Figs. 3, 4, and 5).
A high-magnification view of the stroma shows uninucleated (arrowhead) and multinucleated (arrow) spindle cells scattered throughout the myxoid stroma (Alcian blue stain, x200).
kjo-28-86-g004.jpg
PMC3913986_01_kjo-28-86-g004.jpg
F4
The myxoid tissue was positive on Alcian blue staining (pH 2.5), and a few scattered fibroblasts were observed on hematoxylin and eosin (H&E) staining (Figs. 3, 4, and 5).
Marked vacuolar changes in the myxoid corneal stroma (Alcian blue stain, x200).
kjo-28-86-g005.jpg
PMC3913986_01_kjo-28-86-g005.jpg
F5
The myxoid tissue was positive on Alcian blue staining (pH 2.5), and a few scattered fibroblasts were observed on hematoxylin and eosin (H&E) staining (Figs. 3, 4, and 5).
(A) The periphery of the lesion showing a loose, hypocellular, minimal collagen-depositional, glycosaminoglycan-rich lesion in the subepithelial anterior stroma (M), in sharp contrast to the normal deep stroma (N). (B) The central site of the lesion showing vacuolar changes in the deep stroma (V). Masson trichrome stain, x100.
kjo-28-86-g006.jpg
PMC3913986_01_kjo-28-86-g006.jpg
F6
Moreover, the central site of the lesion exhibited vacuolar change beneath the myxoid tissue (Fig. 6).