Eye
Cornea
Bullous keratopathy
Author: Nat Pernick, M.D.
Last author update: 1 October 2013
Last staff update: 17 April 2024
Copyright: 2004-2024, PathologyOutlines.com, Inc.
PubMed Search: Bullous keratopathy pathology
Cite this page: Pernick N. Bullous keratopathy. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyecorneabullouskeratopathy.html. Accessed April 24th, 2024.
Bullous keratopathy
Definition / general
Microscopic (histologic) description
- Injury to endothelium (does not regenerate) which normally pumps fluid out from corneal stroma
- Leads to chronic edema of stroma and epithelium, subepithelial bullae, pain, eventually diffuse scarring and reduced vision
- Called aphakic bullous keratopathy if after cataract extraction
- Causes include
- Immunologic rejection of corneal endothelium
- Fuchs dystrophy
- Implantation of prosthetic intraocular lens
Microscopic (histologic) description
- Intraepithelial vesicles
- Bullae between epithelium and Bowman layer
- Fewer endothelial cells than normal
- Increased corneal thickness with loss of normal artifactual clefts between collagen lamellae
Aphakic bullous keratopathy
Definition / general
Microscopic (histologic) description
- Secondary endothelial compensation, often after cataract extraction (with or without an intraocular lens)
- Resembles Fuchs dystrophy
- Causes severe visual loss and astigmatism
Microscopic (histologic) description
- Corneal edema with bullae between corneal epithelium and Bowman layer
- Late changes are replacement of bullous cavity with fibrous tissue
- No / attenuated endothelium
