The use of tissue plasminogen activator in post-traumatic total hyphaema

Background: We wanted to evaluate whether intracameral injection of tissue plasminogen activator (tPA) is useful in managing traumatic hyphaema. Methods: Two eyes with total hyphaema after a severe penetrating injury were treated with a single intracameral injection of 25 g of tPA 5 and 14 days after the injury, respectively. Results: Most of the blood coagulum dissolved within 24 h, and in one of the two eyes the intraocular pressure decreased from 45 to 8 mmHg. The other eye was hypotonic. No re-bleeding or complications related to the use of tPA were noticed. Conclusion: The results in these two cases suggest that tPA is a useful adjunct in managing total hyphaema.     

Effect of corticosteroids on healing of the corneal endothelium in cats

Background: Anterior segment surgery is frequently complicated by damage to the corneal endothelium. We examined the effects of corticosteroids, which are widely used for the suppression of postoperative inflammation, on the process of endothelial cell regeneration. Methods: The effect of corticosteroids on healing of the corneal endothelium was examined in 10 domestic cats. In both eyes a circular area, 8 mm in diameter, was scraped off at the center of the corneal endothelium without damaging Descemet's membrane. Immediately after scraping, as well as 2 and 5 days later, each animal received a unilateral retrobulbar injection of betamethasone sodium phosphate (2 mg). The other eye served as a control and received a retrobulbar injection of the vehicle only. Results: Evaluation of the corneal endothelium 2, 5 and 7 days after the trauma revealed that relative to the control contralateral eyes, the corticosteroid-treated eyes exhibited a higher mean coefficient of variation of the corneal endothelium cell area, fewer hexagonal cells, a larger number of polygonal cells with 3, 4, 7 and 8 cellular facets, thinner corneas and less inflammation. Conclusions: These findings suggest that corticosteroids unfavorably affect the regeneration of corneal endothelial cells after injury. As corticosteroids appear to have both positive and adverse effects on corneal function after trauma, they should be used with caution.     

Essentielle (benigne) Hypertonie und Augenhintergrund

Zusammenfassung An 130 Patienten wird der Nachweis geführt, daß die essentielle (benigne) Hypertonie kein eigenes Augenhintergrundsbild bestizt. Ganz abgesehen von der Häufigkeit eines unveränderten Augenhintergrundes, die beobachteten Retinagefäßveränderungen gehen nicht über jenes Maß hinaus, wie es älteren Personen überhaupt zusteht; sie finden in Alterkslerose eine treffende Bezeichnung. Namengebungen wie Fundus hypertonicus oder Retinitis hypertonica und dergleichen sind auf das Gebiet der malignen Hypertension bzw. malignen Nephrosklerose verwiesen.     

The ultrastructure of parapapillary chorioretinal atrophy in eyes with secondary angle closure glaucoma

Background: The present study was performed to investigate the ultrastructure of deep retinal layers and choroid corresponding to the parapapillary chorioretinal atrophy in eyes with secondary angle-closure glaucoma. Methods: The glaucomatous eyes included two eyes enucleated due to iris ring melanoma with high intraocular pressure and one eye with neovascular glaucoma enucleated due to ocular pain. The control eyes included one eye enucleated due to choroidal malignant melanoma with normal intraocular pressure and one eye enucleated during surgery for supramandibular carcinoma. These eyes were studied with light and electron microscopy. Results: In the region of parapapillary chorioretinal atrophy of glaucomatous eyes, the retinal pigment epithelial cells showed degenerative changes, such as loss of basal in foldings and microvilli, degenerated mitochondria, vacuolar degeneration and irregular distribution of melanin granules. The photoreceptors were decreased in number in this area of glaucomatous eyes. The lumen of the choriocapillary vessels adjacent to the optic nerve was collapsed. Conclusion: These results elucidate the fine structures of deep retina and choroid in the region of parapapillary chorioretinal atrophy of glaucomatous eyes, and suggest that the reduced choroidal perfusion might be the pathogenetic mechanism of glaucomatous parapapillary chorioretinal atrophy.     

Course of the optic nerve fibers through the lamina cibrosa in human eyes

Background: This study investigated whether regional variations in the course of the optic nerve fibers through the lamina cribrosa may be one of the reasons why the local susceptibility for glaucomatous optic nerve fiber loss differs among the various regions of the optic disc. Methods: The study included 34 human eyes enucleated because of a malignant melanoma of the peripheral choroid without involvement of the anterior chamber angle or the optic nerve. Anterior-posterior sections through the pupil and the optic disc were histomorphometrically evaluated. In the central region and the peripheral part of the optic disc, we measured the thickness of the lamina cribrosa and the length of the lamina cribrosa channels through which the nerve fibers pass. Results: In the peripheral parts of the disc, compared with its central region, the lamina cribrosa was significantly thicker (P<0.0001, Wilcoxon test), the lamina cribrosa channels with the nerve fibers passing through were significantly longer (P<0.0001), and the ratio of length of the fiber channels to the thickness of the lamina cibrosa was significantly higher (P=0.0001). Conclusion: The lamina cribrosa is thicker and the course of the optic nerve fibers through the lamina cribrosa is more curvilinear in the disc pheriphery than in the disc center. These variations in the anatomy of the lamina cribrosa may be one of several factors influencing the regional susceptibility for glaucomatous optic nerve fiber loss within the optic nerve head.     

Pattern VEP is a useful technique in monitoring the effectiveness of occlusion therapy in amblyopic eyes under occlusion therapy

Purpose To evaluate the effectiveness and clinical significance of pattern visual evoked potential (P-VEP) parameters on visual acuity in amblyopic patients under occlusion therapy.Methods A total of 34 consecutive children with anisometropic amblyopia were included in this study. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all cases and binocular vision was tested and recorded with Worths four-dot test and Bagolini striated glasses at each visit. Part-time occlusion therapy was performed by using adhesive patches.Results The mean (±SEM) cycloplegic refractive error was +5.6± 0.6 diopters (D) in the amblyopic eyes and +1.8±0.2 D in the normal eye. The mean levels of best-corrected visual acuity were statistically differed between each measurement for occlusion therapy (for each, p<0.05). The ratio of the patients with binocular vision increased after 6months occlusion therapy and the difference was statistically significant (p<0.05). In addition, P100 amplitude improved at each visit and the difference was significant when compared with baseline values (for each,p<0.05).Conclusions P100 amplitude of the P-VEP test parallels the improvement in subjective visual acuity in amblyopic eyes under occlusion therapy. Therefore, this test may be useful in monitoring the visual acuity in the preverbal or non-verbal patched patients.     

The basement membrane complex of the human corneal epithelium

The present report reviews the fine structure of the basement membrane zone or complex in the normal human cornea and describes its alterations in cases of early and acute keratoconus. In normal human cornea the basement membrane zone is formed by a basal lamina (with a lamina lucida and a lamina densa), special fibrils, collagen fibrils and assemblies of filaments. These components are less evident in the central region of the cornea than in its periphery. In early stages of keratoconus the basement membrane zone is thickened and the lamina densa displays an irregular course. In acute keratoconus, the basement membrane zone is also thickened and includes a large number of special fibrils as well as bundles of microfibrils (oxytalan fibers). The conclusion that the basement membrane complex of the corneal epithelium is equivalent to the epidermal-dermal junction of the skin is discussed.This paper was presented in part at the Eighth Annual Meeting of the European Club for Ophthalmic Fine Structure in West Berlin on 28^th, 29^th March, 1980     

Therapeutic use of the 193-nm excimer laser in corneal pathologies

Purpose: To analyze the results of phototherapeutic keratectomy. Patients and methods: We performed 193-nm excimer laser phototherapeutic keratectomy (PTK) in 252 eyes of 216 patients suffering from pain and/or decrease in visual acuity. One hundred and three eyes had recurrent erosions of the cornea, 86 eyes underwent excimer laser smoothing of the cornea after pterygium surgery, 29 eyes had a bandlike keratopathy (25 rough, 4 smooth) and 34 eyes had other pathologic conditions such as amyloidosis of the cornea, anterior corneal dystrophies, scars after injuries, alkali burns, superficial stromal dystrophies and infections. Recurrent erosions and epithelial dystrophies were treated with 15–20 pulses (160–200 mJ/cm², 8 mm ablation zone) after mechanical abrasion of the epithelium. Removal of corneal opacities and scars required the use of a masking fluid (methylcellulose) in different concentrations and slit-lamp control (integrated in the delivery system of the excimer laser). Results: Some 91% of the eyes with recurrent erosions were recurrence-free. Fifty-two per cent of the eyes with pterygium had recurrences if the baresclera technique was used and 33% of the eyes if a free conjunctival graft was used. The difference was not significant. All of the patients with bandlike keratopathy were pain-free. In 88% of the eyes with special indications the treatment goal was achieved. No positive effect was seen after alkali burn, in a patient with anterior membrane dystrophy (Grayson-Wilbrandt corneal dystrophy) or in a patient with a corneal protuberance. In one patient with scleroperikeratitis a late recurrence of the opacity was observed 3 years after surgery. A loss of best corrected visual acuity was found only in one patient with bullous keratopathy in whom the treatment goal was the reduction of pain. All patients with smooth bandlike keratopathy had an improvement in best corrected visual acuity of at least one line. About 70% of patients with special indications improved by at least one line, up to nine lines. A possible hyperopic shift in all groups could be minimized using a large ablation zone. Conclusion: PTK with the 193-nm excimer laser is a safe and effective treatment for many superficial diseases of the cornea.Werner Förster is the Primary Investigator for Schwind Keratom     

Self-assessment of angles of strabismus with photographic Purkinje I and IV reflection pattern evaluation

Background: Accurate assessment of the angle of strabismus, e.g. of variable angles of strabismus, is crucial in preoperative patient management and is usually performed in a clinical environment. Objective assessment by patients themselves, under everyday conditions, could contribute to a better preoperative work-up. A new objective evaluation procedure for the measurement of manifest angles of strabismus for near and distance fixation by the patient himself is presented. Methods: To account for the modified experimental setup used for the self-assessment, an amended computation procedure of Purkinje reflection pattern evaluation was developed. For measurement, patients and controls placed their head on a head/chin rest and fixated at 33 cm or 4 m distance in primary position. A reflex camera and three photo flash units were positioned on a special frame underneath the visual axis and in front of the subject so that both eyes could be photographed simultaneously. The camera's remote shutter control was released together with the photo flash units by the properly fixating subject. The angles of strabismus were obtained from the series of pictures through later evaluation of the Purkinje I and IV reflection patterns recorded in the photographs of the eyes. Results: Measurements of the ocular alignment in two control groups and in a group of strabismic subjects showed satisfactory accuracy of the self-assessment method compared to standard Purkinje reflection pattern evaluation and orthoptic measurements of the angle of strabismus. Conclusion: The modified self-assessment method can be used for the objective recording of angles of strabismus as needed in the preoperative work-up of patients with variable angles of strabismus, over prolonged periods of time, and outside a clinical setting.Presented in part as a poster at the 88th Annual Meeting of the Deutsche Ophthalmologische Gesellschaft in Baden-Baden, 1990     

Detection of herpes simplex virus after penetrating keratoplasty by polymerase chain reaction: correlation of clinical and laboratory findings

Background: The study was carried out to investigate the possible correlation of clinical findings, histopathologic features and detection of herpes simplex virus DNA in corneal buttons obtained after penetrating keratoplasty. Methods: We examined 47 consecutive corneal buttons sent for histopathologic examination by light microscopy and using the polymerase chain reaction for the detection of HSV1 and HSV2. Twenty-one corneal buttons from eyes with bullous keratopathy served as controls. Results: The 47 cases were graded from the clinical information available as unproven, suspected and clinically proven cases of herpetic keratitis. This grading did not correlate to specific histopathologic features or to the results of HSV1 DNA testing. None of the cases were positive for HSV2 DNA. Conclusion: HSV DNA was detected in some of the cases of clinically unsuspected herpetic keratitis. This technique of demonstrating the presence or absence of HSV in the cornea after keratoplasty is more reliable than clinical data or histopathologic findings and may be important in cases of recurrent inflammatory episodes involving grafts after keratoplasty.Presented in part at the meeting Frontiers in Penetrating Keratoplasty on 22 September 1994, Heidelberg, Germany     

Experimental microendoscopic photoablative laser goniotomy as a surgical model for the treatment of dysgenetic glaucoma

Purpose: The aim of this study was to investigate the feasibility of photoablative Er:YAG laser goniotomy under microendoscopic control in a surgical cloudy corneal model of primary infantile glaucoma. Methods: Pectinate ligaments of 12 freshly enucleated cadaver porcine eyes were treated by ab interno single-pulse (5 mJ, 200 s) Er:YAG laser (2.94 m) photoablation. Through a clear corneal incision near the limbus an ophthalmic microendoscope (18 and 20 gauge) was inserted into the anterior chamber. Internal structures were observed and photoablative laser goniotomy was conducted under video guidance. Following treatment all eyes were prepared for light and scanning electron microscopy. Results: Anterior chamber angle structures and tissue photoablation were clearly visualized on the videoscreen using ophthalmic microendoscopy. Energy settings of 5 mJ per pulse proved to be sufficient for reproducible photoablation of pectinate ligaments, accompanied by the root of the iris falling back and exposing trabecular meshwork. This was confirmed histopathologically. Scatter thermal damage was less than 30 m. Conclusion: This new therapeutic modality, which combines endoscopic visualization of the internal structures with photoablative laser goniotomy, can be effective in the management of dysgenetic glaucoma in the presence of a cloudy cornea. High reproducibility of contact laser photoablation enabled sufficient control of incision depth and was not accompanied by inadvertent tissue damage to adjacent intraocular structures.     

Toxicity and efficacy of intravitreal injection of spartanamicin B* in the treatment of Candida endophthalmitis **

Aims/Background: We evaluated the retinal toxicity of spartanamicin B and its efficacy in a rabbit model of Candidal endophthalmitis. Methods: Toxicity. Fourteen albino rabbit eyes were injected intravitreally with spartanamicin B (1, 2, 5, 10, 25, 50, and 100 g) ; 2 eyes received the vehicle alone. Efficacy. Ten rabbit eyes were inoculated with 3000 Candida organisms which caused endophthalmitis in 24 hours. Eight eyes were treated with intravitreal spartanamicin B in doses of 1, 2, 5, or 10 g/0.1 ml; 2 untreated eyes served as controls. Results: Toxicity. The eyes injected with 10 g and the control group eyes exhibited no clinical, histological, or electroretinographic evidence of retinal toxicity. Doses > 10 g caused vitritis. Efficacy. Clinical examination of the treated eyes showed a gradual improvement over 3–6 days; mild opacities remained until day 14. Results of cultures performed 15 days after infection were negative in all treated eyes. Conclusions: Intravitreally injected spartanamicin B (10 g) is nontoxic to the retina, effective against C. albicans in the endophthalmitis model in the rabbit eye and caused no discernible histological changes in the retina.     

Corneal neovascularization in rats as a model for photothrombotic therapy using bacteriochlorin a and an argon laser

Background: The presence of vessels has a negative influence on corneal transplant survival. Closure of such vessels prior to transplantation may improve the transplant results, and this might be achieved by irradiating the vessels with argon laser light after intravenous administration of a photosensitizer, e.g. bacteriochlorin a (BCA). A suture-induced corneal neovascularization model in rats was set up to test this hypothesis. Methods: Suture-induced vessels in the cornea of male Wistar rats were irradiated with argon laser light after intravenous administration of BCA. We applied irradiation of varying energy levels and duration and assessed the changes in the vessels by slit-lamp examination, fluorescein angiography and histology. Results: Suture-induced corneal vessels in the rat could be used effectively to study photothrombosis therapy. Intravenous administration of BCA prior to irradiation (=514.5 nm) of the corneal vessels led to vessel closure at lower energy levels and of longer duration than occurred with laser treatment alone. Conclusion: Suture-induced corneal neovascularization in the rat can be used as a model to study the efficacy of photothrombosis therapy. BCA can be used to enhance the rate and duration of vessel closure.     

Inhibition of corneal allograft reaction by CTLA4-Ig

Background: Activation of T cells requires both the interaction of T-cell receptor with major histocompatibility complex on the antigen-presenting cell and costimulatory signals, for instance the B7 antigens expressed on antigen-presenting cells and the CD28 molecule expressed on T cells. A recombinant fusion protein, CTLA4-Ig, has been produced that contains the extracellular domain of human CTLA4 fused to IgGl constant region and that binds the B7 molecule with high affinity. Blocking the CD28/B7 interaction with CTLA4-Ig inhibits T cell activation in vitro and in vivo. Methods: We used CTLA4-Ig in a fully MHC-mismatched mouse keratoplasty model. The animals were divided into four groups: (1) no treatment, (2) intraperitoneal treatment with 130 g CTLA4-Ig, (3) intraperitoneal treatment with 300 g CTLA4-Ig, (4) subconjunctival treatment with 290 g CTLA4-Ig. Results: The allograft reaction occurred in untreated animals between days 12 and 16 (mean 13.5). While topical application of CTLA4-Ig seemed to shorten the graft survival (mean 11.6 days) and systemic application of 130 g had no influence (mean 14.0), only intraperitoneal injection of 300 g of CTLA4-Ig prolonged the survival of allografts (mean >20 days) (P<0.01). Conclusion: CTLA4-Ig prolonged significantly the survival of corneal allografts in a fully MHC-mismatched mouse keratoplasty model, but the small antigen load of the corneal transplant and the anterior chamber-associated immune deviation (ACAID) may have a disadvantage to induce tolerance in this model of CTLA4-Ig therapy.Presented at JERMOV 1996 in Montpellier     

Increased release of tenascin in tear fluid after photorefractive keratectomy

Background: Extracellular matrix protein tenascin (TN) is expressed in the anterior stroma during corneal wound healing. In this study we analysed TN release in tear fluid after photorefractive keratectomy (PRK). Methods: Tear fluid TN concentrations of ten PRK patients were measured with an immunoassay. Tear fluids were collected preoperatively and 1, 2 and 7 days after PRK. The tear fluid collection time and the volume of tears collected were registered. Because tear fluid flow was greatly increased postoperatively, tear fluid flow-corrected release (TN flux) was calculated. Results: The tear fluid flow was 4.50±0.94 l/min (mean±SEM) preoperatively, 55.48±16.70 l/min (P<0.01) on the 1st, 33.91±7.91 l/min (P<0.01) on the 2nd, and 13.79±5.49 l/min (P>0.05) on the 7th postoperative day. The preoperative TN concentration was 0.85±0.20 g/ml. On the 1st postoperative day it decreased to 0.37±0.17 g/ml (P>0.05), most likely due to the dilution effect caused by hypersecretion after PRK. The TN concentration was 0.67±0.12 g/ml (P>0.05) on the 2nd and 0.78±0.15 g/ml (P>0.05) on the 7th postoperative day. The preoperative TN flux was 5.23±1.88 ng/min. On the 1st and 2nd postoperative days the TN flux was 14.40±4.99 ng/min (P<0.05) and 22.66±6.I2 ng/min (P<0.05), respectively. On the 7th postoperative day a tendency towards decreased flux (14.00±6.02 ng/min, P>0.05) was observed. Conclusion: Although there is a minor decrease in TN concentration after PRK due to increased tear fluid flow, a significant increase in TN flux was observed. Complete reepithelialization of the ablated area was observed in all eyes at the follow-up visit on postoperative day 7.     

The Effect of the Corneal Epithelium on the Intraocular Penetration of Fluoroquinolone Ophthalmic Solution

Purpose Pharmacokinetic studies of antibacterial agents for infectious eye diseases have usually been performed on normal rabbit eyes. In this study, the intraocular penetration of fluoroquinolone ophthalmic solutions was determined in normal rabbit eyes and in rabbit eyes that had the corneal epithelium intentionally removed.Methods We determined the intraocular penetration of ofloxacin (OFLX), levofloxacin (LVFX), and norfloxacin (NFLX), fluoroquinolone ophthalmic solutions that are already on the market and undergoing clinical studies, by injecting 50µl of each solution into the cul-de-sacs of rabbit eyes three times at 15-min intervals. The drug concentration at 10, 30, 60, 120, and 240min after final instillation was determined by high-performance liquid chromatography.Results The maximum concentration in the aqueous humor of normal rabbit eyes was 2.09 ± 1.56µg/ml (60min, OFLX), 2.57 ± 1.00µg/ml (30min, LVFX), and 0.42 ± 0.12µg/ml (120min, NFLX). The drug concentration in the aqueous humor of eyes with intentionally removed corneal epithelium was 12.50 ± 5.62µg/ml (30min, OFLX), 9.02 ± 2.45µg/ml (60min, LVFX), and 8.54 ± 5.17µg/ml (30min, NFLX). The drug penetration of the eye drops into eyes with removed corneal epithelium was around 6 times (OFLX), 3.5 times (LVFX), and 20 times (NFLX) higher than the penetration into the eye with normal cornea.Conclusion Among the pharmacokinetic parameters of the three ophthalmic solutions according to the one-compartment model, the maximum concentration in the aqueous and the area under the concentration–time curve in the aqueous tended to be higher in the eyes with intentionally removed corneal epithelia than in those with normal corneas. Jpn J Ophthalmol 2004;48:93–96 © Japanese Ophthalmological Society 2004     

Lamellar excimer laser keratoplasty: Reproducible photoablation of corneal tissue

We examined the depth of ablation of the recipient bed with different counts of oscillations of excimer laser beam, to determine the correlation between planned and real depth. The ablation rate per oscillation was tested preoperatively by blackened photographic paper of defined thickness and thus was calculated to be 5 m. Forty pig eyes were used for the first study. Each eight eyes were ablated in the planned depth 100 m, 200 m, 300 m, 400 m and 500 m. The corneal thickness was measured with an ultrasonic pachymeter before and after the procedure. The depth measured after the photoablation was 99.4 ± 36.4 m for 100 m planned depth, 186.7 ± 55.3 m for 200 m, 298.4 ± 68.5 m for 300 m, 373.9 ± 65.7 m for 400 m and 480.1 ± 59.3 m for 500 m. Comparing the depth measured after the photoablation to planned depth, there was a significant correlation (correlation coefficient: R = 0.93; p < 0.0001). Five other corneas trephinated from pig cadaver eyes were ablated from the endothelial side to the desired thickness (100 to 500 m) of lamellar graft. In a second step a donor mask was placed onto the cornea and a laser light spot was led until perforating on all sides. The lamellar keratoplasty was completed by suturing the corneal graft into the bed. Macroscopic and microscopic examination of sutured eyes after fixation showed a good fit of wound margins and stromal interface. These results indicate that excimer laser is useful for reproducible corneal photoablation in lamellar keratoplasty.     

Zum Erscheinungsbild der kongenitalen ektodermalen Dysplasien

Zusammenfassung An Hand von 7 Kindern werden die vielgestaltigen Symptome der kongenitalen ektodermalen Dysplasien als zu den multiplen Abartungen gehöriges Krankheitsbild besprochen. Die sehr seltene Kombination der ektodermalen Dysplasien mit Mißbildungen der Tränen-Nasenwege und Pili torti wird hervorgehoben. Bei einem Kind lassen sich die Zeichen einer gleichzeitig bestehenden, an Dysostosis cleidocranialis erinnernden Mischform mit ektodermaler Dysplasie finden. Neben dem nachgewiesenen dominanten Erbgang besteht die Möglichkeit peristatisch bedingter Phänokopien.Mit 10 Textabbildungen     

Anterior segment findings in AIDS patients with cytomegalovirus retinitis

Background: Anterior segment findings in AIDS patients presenting with cytomegalovirus (CMV) retinitis have not been specifically addressed in the American literature. Methods: Our study evaluated 21 AIDS patients with CMV retinitis. Results: Nineteen (90%) of these patients exhibited corneal endothelial deposits concurrent with CMV retinitis. The endothelial deposits were microscopic, opaque, linear flecks arranged in a reticular-like fashion. Of 42 eyes evaluated, 32 (76%) demonstrated active CMV retinitis. Corneal endothelial deposits were noted in 26 (81%) of the 32 eyes with retinitis. These corneal endothelial deposits were absent in the eyes which did not have CMV retinitis. Conclusion: Meticulous examination of the retina of an HIV-positive or AIDS patient who presents with reticularly arranged, linear, flecked corneal endothelial deposits should be performed to ensure that the diagnosis of CMV retinitis can be ruled out.     

Corneal endothelial wound repair in normal and mitotically inhibited cultures

Background: The aim of the present study was to compare the morphology, proliferative activity and cytoskeletal organization of bovine corneal endothelial cells during wound healing under normal and mitotically inhibited conditions. Methods: Cell cultures were grown to confluency and incubated with the mitotic inhibitor 5-fluorouracil (5-FU; 2.5 g/ml) followed by a touch wound. Control cultures were maintained without 5-FU. Mitotic activity, F-actin, vinculin, vimentin and connexin 43 localization were evaluated before, during and after wound closure. Results: 5-FU inhibited irreversibly the mitotic activity of corneal endothelial cells during the whole wound healing process. In the presence of 5-FU, a high degree of polymegathism and delay in actin and vinculin redistribution to the cell borders after wound closure was observed. Vimentin and connexin 43 immunolabeling revealed only slight differences between 5-FU-treated and control cultures. Conclusion: Significant changes in cell geometry and cytoskeletal organization in the amitotic corneal endothelium became manifested only after wounding. These changes may influence cell-cell and cell-matrix interactions as well as functional restoration of the monolayer after wound closure.