Electron micrographs of the central part of a normal cornea and keratoconus (KC) cornea. Electron micrographs of the central part of a normal cornea and.

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Electron micrographs of the central part of a normal cornea and keratoconus (KC) cornea. Electron micrographs of the central part of a normal cornea and keratoconus (KC) cornea. (A) Part of the anterior stroma in the normal cornea showing tight interlacing (white arrowheads) of the lamellae (L). (B) Part of the posterior stroma in the normal cornea showing parallel running lamellae (L). A keratocyte (KR) is lying flat between the parallel lamellar layers in the posterior stroma. (C) Part of the subepithelial region of KC cornea showing localised absence of basement membrane and Bowman’s layer, with the epithelial cell (EP) resting on the lamellae (L). A keratocyte (KR) with prominent nucleus (N) was present between lamellae. (D) Part of the subepithelial region (EP) of KC cornea showing a break in the Bowman’s layer (BW) resulting in a direct contact of basement membrane (BM) with anterior stroma (AS). (E) Part of the anterior stroma of KC cornea showing loose interlacing (white arrowhead) and severely disoriented collagen fibrils (black arrowheads) with patches of electron-dense granular material (*), below the Bowman’s layer (BW). Part of a keratocyte (KR) appears between the interlacing lamellae. (F) Undulating lamellae (U) in the anterior stroma of KC cornea crushing a keratocyte (KR). Please note the crease (C) in the Bowman’s layer (BW). (G) Part of the posterior stroma of KC cornea showing a keratocyte (KR) crushed between the severely undulated lamellae (U). (H) Part of the interface of the posterior stroma and Descemet's membrane (DM) in KC cornea showing the presence of the undulations (U) just above the DM. Aljoharah Alkanaan et al. Br J Ophthalmol doi:10.1136/bjophthalmol-2016-309834 ©2017 by BMJ Publishing Group Ltd.