ANGIOGENESIS IN CORNEAL DISEASES - HISTOPATHOLOGIC EVALUATION OF 254 HUMAN CORNEAL BUTTONS WITH NEOVASCULARIZATION

Purpose. Angiogenesis in corneal diseases can necessitate corneal tran splantation and induce graft rejection. The aim of this study was to f ind out the histopathologic prevalence of angiogenesis in human cornea s removed during keratoplasty, to establish the histopathologic diagno ses most commonly associated with angiogenesis, and to evaluate the an atomic location of new corneal vessels. Methods. Corneal buttons (2,55 7) after keratoplasty were sent to and analyzed in our ophthalmopathol ogy laboratory between 1992 and 1996. Of these, 1,278 full-thickness a nd lamellar corneal buttons were randomly retrieved and evaluated in t his study. Results. Of 1,278 human corneal buttons obtained by keratop lasty, 254 (19.9%) showed angiogenesis. Associated histopathologic dia gnoses were (a) scarring after keratitis (109, 45.4%); (b) graft rejec tion and insufficiency (73, 30.4%); (c) acute necrotizing ulcerative k eratitis (30, 12.5%); and (d) scarring after mechanical or chemical in juries (28, 11.7%). Histopathologically, new vessels were usually asso ciated with corneal edema or inflammatory cells or both (76%). The mos t common locations of new vessels were the upper and middle third of t he corneal stroma. Only 11% of new vessels were located solely in the deep stromal layers. Conclusion. Angiogenesis is a common histopatholo gic feature of corneal diseases leading to corneal transplantation and was found in 19.9% of excised human corneal buttons. Systemic or topi cal antiangiogenic therapy could reduce the need for corneal transplan tation and retransplantation.