Model of Epithelial Downgrowth

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Abstract
Ten cats have been carefully studied for progression of epithelial downgrowth after a reversed corneal transplant incorporating a conjunctival flap into the anterior chamber and peripheral anterior synechia to the iris. This animal model closely approximates the human condition seen clinically and histologically in the following areas: low-grade uveitis is present; pre-Descemet's vascularization is a harbinger of occult epithelial downgrowth; peripheral anterior synechiae contribute to corneal vascularization; gradual iris distortion may indicate a hidden membrane; a corneal membrane may be a late manifestation of anterior chamber epithelialization; corneal edema may follow late after epithelialization of the cornea due to the barrier function of epithelium blocking fluid influx into the cornea; the absence of corneal vascularization is associated with slower progression over the corneal endothelium compared to the nutrient stromal vessels; and the movement of attenuated epithelial cells may not be differentiated from fibroblasts or diseased endothelial cells without the use of pre-keratin antibody staining. We feel that without alcohol fixation of human specimens and adequate pre-keratin AB staining, the occult epithelial downgrowth may be frequently overlooked clinically and misinterpreted pathologically.

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