case_images: PMC11829923_01
case_images: A Right corneal ulcer stained greenish with fluorescein involving nearly the whole cornea which was almost completely melted down with remaining Descemet's membrane. B Right cornea showed resolution of ulceration and disappearance of greenish staining with fluorescein except for a few scattered spots. C Right corneal descemetocele (yellow arrows) protruding forward, and the intraocular lens (white arrow) partially protruding from the pupil and indenting the Descemet's membrane
case_images: 795_2024_405_Fig1_HTML.jpg
case_images: PMC11829923_01_795_2024_405_Fig1_HTML.jpg
case_images: Fig1
case_images: In our previously published clinical case report of whole corneal descemetocele after infective corneal ulcer, we described an old male farmer presented with right infective corneal ulcer (positive fluorescein staining) involving nearly the entire cornea (Fig. 1A), which was almost completely melted down with the remaining Descemet's membrane (DM). After the corneal inflammation had settled down within 2 weeks of hospitalization and intensive treatment, the cornea showed negative staining for fluorescein (Fig. 1B) observed over the transparent and thin remaining membrane which was indented by protruding intraocular lens (Fig. 1C).
case_images: A TEM image showing the many layered structures that consist of two different types of cells. The first type of cell consists of lighter staining polygonal cells (black arrows), while the second is formed of elongated cells (yellow arrows) with relatively dense staining. (Star = ECM; arrowhead = intracellular spaces and white arrow = macrophage) (Bar = 2 microm). B TEM image showing the parallel layers of elongated cells (yellow arrows) attached to each other with multiple gap junctions (arrowheads). (White arrows = stress fibers) (Bar = 500 nm)
case_images: 795_2024_405_Fig2_HTML.jpg
case_images: PMC11829923_01_795_2024_405_Fig2_HTML.jpg
case_images: Fig2
case_images: TEM examination of the specimen revealed many layered structures that consisted of two different types of cells attached to each other (Fig. 2A). The first type of cells was the lighter staining polygonal cells, while the second type consisted of elongated cells with a relatively dense staining (Fig. 2A). All cells were connected with a large number of gap or adherens junctions, with intercalation of the cell membranes with adjacent cells (Fig. 2B). Between the elongated cells that contained large amounts of debris, macrophages were detected (Fig. 2A).
case_images: A TEM image showing the haphazard distribution of cytoplasmic microfilaments in one elongated cell (Bar = 500 nm). B TEM image showing part of the remanent of Descemet's membrane (white arrow) that is attached to atrophied featureless iris tissue (black arrows), which contains melanosomes (star) (Bar = 2 microm)
case_images: 795_2024_405_Fig3_HTML.jpg
case_images: PMC11829923_01_795_2024_405_Fig3_HTML.jpg
case_images: Fig3
case_images: Both types of cells contained a haphazard distribution of cytoplasmic microfilaments, especially the elongated cells (Fig. 3A). Also, there was no evidence of the presence of DM, with the exception for a small remanent part adjacent to the atrophied disorganized iris tissue that contained some melanosomes (Fig. 3B).