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Cited by 424Corneal surgery and disordersCorneal Surgery and TreatmentsOcular Surface and Contact Lens

The specific architecture of the anterior stroma accounts for maintenance of corneal curvature

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Muller, L. J·2001·British Journal of Ophthalmology
DOI 10.1136/bjo.85.4.437PMC PMC1723934
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Abstract

AIM: To analyse the human corneal stroma in extreme hydration to discover if its structure is responsible for corneal stability. METHODS: Corneas in several hydration states were used: postmortem control corneas (PM; n=3), corneas left for 1 day in phosphate buffered saline (PBS; n=4), and corneas left for 1 day (n=4), 2 days (n=4), 3 days (n=2), and 4 days (n=4) in deionised water. All corneas were fixed under standardised conditions and processed for light and electron microscopy. In addition, two fresh corneas from the operating theatre were studied which were processed 6 months after storage in sodium cacodylate buffer. RESULTS: After 1 day in deionised water maximal stromal swelling was reached which did not change up to 4 days. The stroma of deionised water corneas (1400 microm) was much thicker than that of PBS corneas (650 microm) and PM corneas (450 microm). Deionised water treatment led to disappearance of all keratocytes leaving only remnants of nuclei and large interlamellar spaces. In these specimens the distance between the collagen fibres had increased significantly, but the diameter of the collagen fibres did not seem to be affected. A remarkable observation was that the most anterior part of the stroma (100-120 microm) in all deionised water specimens and those stored for 6 months in buffer was not swollen, indicating that the tightly interwoven anterior lamellae are resistant to extreme non-physiological hydration states. CONCLUSIONS: The rigidity of the most anterior part of the corneal stroma in extreme hydration states points to an important role in maintenance of corneal curvature. Since a large part of this rigid anterior part of the stroma is either removed (PRK) or intersected (LASIK), it is possible that in the long run patients who underwent refractive surgery may be confronted with optical problems.

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  • The posterior stroma can swell easily whereas the more interwoven anterior stroma cannot.

    “The posterior stroma can swell easily whereas the more interwoven anterior cannot (Müller et al., 2001).”

    From Corneal structure and transparency (2015) · cites this paper as Müller et al., 2001

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Authors
Muller, L. J.
Venue
British Journal of Ophthalmology
Publisher
BMJ
Published
2001-04-01
Volume
85
Issue
4
Pages
437-443
ISSN
0007-1161 (ISSN-L)
DOI
10.1136/bjo.85.4.437
PMC
PMC1723934
OpenAlex
W2137942762
Cited by
424
References
0
Citations by year
2026: 10 · 2025: 11 · 2024: 14 · 2023: 13 · 2022: 11 · 2021: 8 · 2020: 15 · 2019: 13 · 2018: 28 · 2017: 20 · 2016: 16 · 2015: 29 · 2014: 19 · 2013: 18 · 2012: 16
FWCI
13.27
Type
journal article
Language
en
Open access
Locations
  • British Journal of Ophthalmology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Corneal surgery and disorders
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Corneal Surgery and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ocular Surface and Contact Lens
Keywords
corneal stroma, corneal curvature, corneal hydration, keratocyte loss, collagen fibers, interlamellar space, corneal rigidity, refractive surgery, photorefractive keratectomy, LASIK, corneal stability
MeSH terms
Analysis of Variance, Collagen, Cornea, Corneal Stroma, Humans, Microscopy, Electron, Postoperative Complications, Sodium Chloride, Water, Corneal Edema, Photorefractive Keratectomy, Corneal Topography, Keratomileusis, Laser In Situ, Lasers, Excimer

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