Ultrastructure of keratoconus with healed hydrops

The corneas of three patients with keratoconus were examined by light and electron microscopy within approximately four months after onset of severe hydrops. The rupture and detachment of Descemet's membrane resulted in formation of extensive ledges. New endothelium completely resurfaced the exposed posterior stroma and the corresponding anterior aspect of the ledges. The endothelium also regenerated considerable basement membrane. In one case, clustered endothelium near the free end of the ledge appeared to have undergone fibrous metaplasia with secretion of extensive fibrillar and basement membrane material.