ON THE PATHOLOGY OF THE IRIDOCORNEAL-ENDOTHELIAL SYNDROME - THE ULTRASTRUCTURAL APPEARANCES OF SUBTOTAL-ICE

The iridocorneal-endothelial syndrome (ICE syndrome) is characterised by corneal failure, glaucoma and iris destruction, Specular photomicro scopical and histological studies of the corneal endothelium in this d isease show a population of abnormal cells named 'ICE-cells'. In many patients some areas of the endothelium are occupied by ICE-cells and o thers by normal cells, an appearance described as 'subtotal-ICE'. Spec ular photomicroscopical observations suggest that ICE-cells and normal endothelial cells may actively interact at the boundary zone where th ey meet. The purpose of this study was to examine the ultrastructural appearances of the boundary zone to gain insight into the cellular pat hology of this region. Thirty-five corneas taken from patients with th e ICE syndrome were examined by light, transmission and scanning elect ron microscopy. The subtotal-ICE appearance was demonstrated in four s pecimens. The morphology of ICE-cells at the boundary zone suggests th at they are non-motile but also implies a general state of high metabo lic activity, Many of the normal endothelial cells in this region are damaged, an appearance which may result from a toxic effect from the n earby ICE-cells.